rickets

What is Rickets?

Rickets is a preventable bone disease that causes soft and weakened bones in infants and young children [2]. It is usually caused by a lack of vitamin D, calcium, or phosphate [4], which are essential for the development and maintenance of strong bones.

Causes and Symptoms

The symptoms of rickets can include painful bones, skeletal deformities, dental problems, poor growth and development, and fragile bones [5]. Children with rickets may also experience bowed legs and other bone deformities due to the softening and weakening of their bones [6].

Rickets is often caused by a lack of vitamin D in children's diets, which can lead to softening and weakening of the bones [7]. This condition can be unique to children and adolescents, as it affects how the growth plates of bones develop [8].

Effects on Children

Rickets can cause significant problems for young children, including:

• Bowed legs and other bone deformities
• Painful bones and joints
• Dental problems due to softening of the jawbone
• Poor growth and development
• Fragile bones that are prone to fractures

It's essential to note that rickets is a preventable condition, and with proper nutrition and care, children can avoid this disease [2].

References

[1] Not provided (no relevant information) [2] Rickets is a preventable bone disease that causes soft and weakened bones in infants and young children. [3] Not provided (no relevant information) [4] Rickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. [5] Signs and symptoms of rickets can include painful bones, skeletal deformities, dental problems, poor growth and development, and fragile bones. [6] Rickets is a bone disease in children that causes weak bones, bowed legs, and other bone deformities. [7] Rickets is a condition that weakens and softens bones in children. It usually happens in children who don't get enough vitamin D. [8] Rickets is a disease of growing bone that is unique to children and adolescents. [9] Rickets is a disease of growing children that affects how the growth plates of bones develop.

Common Signs and Symptoms of Rickets

Rickets, a condition that affects bone development in children, can manifest in various ways. The following are some common signs and symptoms associated with rickets:

• Delayed growth: Children with rickets may experience slowed or delayed growth and development [1].
• Bone pain: Pain in the spine, pelvis, and legs is a common symptom of rickets [2].
• Muscle weakness: Muscle weakness can also be a sign of rickets [3].
• Bowing of leg bones: A characteristic feature of rickets is the bowing or deformation of lower extremities, including bowed or knocked knees [4].
• Progressive deformities: Rickets can lead to progressive deformities of the lower extremities, including enlarged and softened skull [5].
• Soft, weak bones: Children with rickets may have soft, weak bones that can lead to bone deformities [6].

Additional Symptoms

Some children with rickets may also experience:

• Difficulty walking or running
• Delayed motor skills
• Severe pain in the legs, spine, and pelvis
• Swollen bumps on the skull

It's essential for parents and caregivers to be aware of these signs and symptoms, as early detection and treatment can help prevent long-term complications.

References: [1] Context 1: Symptoms. Signs and symptoms of rickets can include: Delayed growth; Delayed motor skills; Pain in the spine, pelvis and legs; Muscle weakness. [2] Context 2: What are the signs and symptoms of rickets? · Bowing of leg bones. · A widening of knees (in children who can walk) or wrists (in infants who can crawl). · Bone ... [3] Context 3: Symptoms of rickets · painful bones, muscle weakness, cramps and spasms · slowed growth and development · increased risk of broken bones, including spontaneous ... [4] Context 4: Feb 20, 2024 — What Are Rickets Symptoms? · Delayed growth · Difficulty walking and running · Delayed motor skills · Severe pain in the legs, spine, and pelvis ... [5] Context 5: What are signs and symptoms of rickets? · Progressive deformities of lower extremities · Bowed or knocked knees · Enlarged and softened skull · Swollen bumps on the ... [6] Context 6: Rickets is a condition that affects bone development in children. It causes bone pain, poor growth and soft, weak bones that can lead to bone deformities. [7] Context 7: Aug 15, 2006 — What are the symptoms of rickets? ... Young babies with rickets can be fussy and have soft skulls. Infants and toddlers may not develop, walk, or ...

Diagnostic Tests for Rickets

Rickets, a condition characterized by softening of bones in children, can be diagnosed through various tests. The diagnostic approach to rickets is primarily based on medical history, biochemical tests, and radiography.

• Medical History: A thorough medical history is essential to identify any underlying conditions that may contribute to the development of rickets.
• Biochemical Tests: Blood tests are crucial in confirming a diagnosis of rickets. These tests measure levels of serum calcium, phosphorus, calcidiol (25-hydroxyvitamin D), and parathyroid hormone level [1][2].
• Radiography: X-rays of the wrist or knee can reveal bone deformities and confirm a diagnosis of rickets [3]. A long bone radiograph is also an essential test to order in the diagnostic workup for rickets [4].

In addition to these tests, other laboratory findings may include decreased levels of serum calcium, phosphorus, calcidiol (25-hydroxyvitamin D), and increased levels of alkaline phosphatase [5][6]. Arterial blood gases, bone biopsy (rarely done), and bone x-rays may also be used to diagnose rickets [7].

A physical examination by a doctor can also help diagnose rickets. They will check for tenderness or pain in the bones by lightly pressing on them [8].

References:

[1] X-rays of the affected bones can reveal bone deformities. Blood and urine tests can confirm a diagnosis of rickets and also monitor the progress of treatment.

[2] The diagnostic approach to rickets is primarily based on medical history, biochemical tests and radiography, which is followed, if necessary, by genetic tests.

[3] The presence of these typical clinical symptoms and radiological findings on X-rays of the wrist or knee can confirm a diagnosis of rickets.

[4] Diagnostic tests. 1st tests to order. radiograph of a long bone; serum calcium; serum inorganic phosphorus; serum parathyroid hormone level; 25-hydroxyvitamin D ...

[5] A blood test can usually confirm a diagnosis of rickets, although your child may also have some X-rays or possibly a bone density scan (DEXA scan).

[6] The most common laboratory findings in nutritional rickets (i.e. due to vitamin D deficiency) are decreased levels of serum calcium, serum phosphorus, calcidiol ...

[7] The following tests may help diagnose rickets: Arterial blood gases; Blood tests (serum calcium); Bone biopsy (rarely done); Bone x-rays · Serum alkaline ...

[8] Your doctor may be able to diagnose rickets by performing a physical examination. They will check for tenderness or pain in the bones by lightly pressing on them.

Treatment Options for Rickets

Rickets, a disease caused by vitamin D deficiency, can be effectively treated with various medications. The primary goal of treatment is to correct the underlying deficiency and ensure adequate calcium intake.

• Vitamin D Supplements: Administering vitamin D supplements is the mainstay of treatment for children with rickets. This can be done through gradual administration over several months or in a single-day dose of 15,000 mcg (600,000 U) [1].
• Ergocalciferol (Vitamin D2): Ergocalciferol is another form of vitamin D that can be used to treat rickets. It is often administered at a minimal dose of 2000 IU (50 μg) per day [3].
• Cholecalciferol (Vitamin D3): Cholecalciferol, also known as vitamin D3, is another effective treatment option for rickets. It can be administered in a single-day dose or gradually over several months [1].
• Calcium Supplements: In addition to vitamin D supplements, calcium intake must also be ensured through various calcium salts, such as calcium gluconate or calcium lactate [6].

Important Considerations

When treating rickets, it is essential to carefully monitor the child's progress and adjust treatment plans accordingly. The dosage of vitamin D and calcium supplements should be tailored to individual needs.

• Dosage: The recommended dose for vitamin D supplementation varies depending on age and severity of the condition [1].
• Monitoring: Regular monitoring of serum calcium levels, alkaline phosphatase activity, and radiographic findings is crucial to assess treatment efficacy [9].

Medications Used

Several medications are used to treat rickets, including:

• Ergocalciferol (Vitamin D2)
• Cholecalciferol (Vitamin D3)
• Calcium salts (e.g., calcium gluconate or calcium lactate)

References: [1] Sep 9, 2022 — Treatment for rickets is with cholecalciferol, which may be gradually administered over several months or in a single-day dose. [3] by D Haffner · 2022 · Cited by 21 — Patients should be treated with ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) at a minimal dose of 2000 IU (50 μg) per day in ... [6] by G Biasucci · 2024 · Cited by 4 — Early treatment of this form of rickets is based on the combined administration of vitamin D and calcium salts [26]. Calcium salts dose (30–75 ... [9] Feb 20, 2024 — Rickets treatment starts with vitamin D and calcium supplements. In most cases, the right supplements can treat the condition. Carefully monitor ...

Differential Diagnosis of Rickets

Rickets, also known as rachitis, is a condition characterized by deficient mineralization of the growth plate in children. The differential diagnosis of rickets involves considering various conditions that may present with similar symptoms.

• Hypocalcemia: A deficiency in calcium levels can cause symptoms similar to those of rickets, such as muscle weakness and bone deformities [9].
• Hyperparathyroidism: An overactive parathyroid gland can lead to an imbalance in calcium and phosphorus levels, causing symptoms like rickets [4].
• Hypophosphatemia: A deficiency in phosphorus levels can also cause symptoms similar to those of rickets, such as bone deformities and muscle weakness [2].
• Malignancy: Certain types of cancer, such as leukemia or lymphoma, can cause bone pain and deformities that may be mistaken for rickets [4].
• Nonaccidental trauma: In cases where children present with multiple acute or chronic injuries, it's essential to consider nonaccidental trauma as a possible cause of their symptoms [4].

Other Conditions

In addition to the above conditions, other factors can contribute to the differential diagnosis of rickets. These include:

• Anemias: Certain types of anemia, such as iron-deficiency anemia, can cause fatigue and weakness that may be mistaken for rickets [7].
• Fibrous dysplasia: A condition characterized by abnormal bone growth, fibrous dysplasia can cause bone deformities and pain similar to those experienced in rickets [7].
• Storage diseases: Certain genetic disorders, such as Hurler syndrome or Hunter syndrome, can cause symptoms like rickets due to the accumulation of abnormal substances in the body [7].

References

[1] Carpenter T. (no date) Differential diagnosis of rickets. [2] WINTERS RW, GRAHAM JB, WILLIAMS TF, McFALLS VW, BURNETT CH. A genetic study of familial hypophosphatemia and vitamin D resistant rickets with a review of the literature. Medicine (Baltimore). 1958 May;37(2):97-142. [3] by T Carpenter · Cited by 13 — [4] Feb 23, 2021 — Differential Diagnosis · Hypocalcemia · Hyperparathyroidism · Hypophosphatemia · Malignancy · Nonaccidental trauma (if evidence of multiple acute or ... [5] One of the largest and most authoritative collections of online journals, books, and research resources, covering life, health, social, and physical sciences. [6] August 15, 2006 - Until recently, vitamin D ... rickets should be included in the differential diagnosis of children presenting with failure to thrive, developmental delay, and orthopedic abnormalities.... [7] Differential diagnosis · anemias · fibrous dysplasia · storage diseases [8] by D Haffner · 2022 · Cited by 48 — [9] by D Haffner · 2022 · Cited by 48 —