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Rickets
What are the early symptoms of rickets?
The early symptoms of rickets are mainly due to the inadequate intake of vitamin D in children, leading to disturbances in the body's calcium and phosphorus metabolism. Early signs usually appear around three months of age in infants, characterized by changes in mental state, restless sleep, frequent crying, and excessive sweating. Increased sweating is often accompanied by cradle cap, where circular bald patches appear on the back of the head. In such cases, it is important to include vitamin D-rich foods in the diet and supplement with vitamin D. Continued breastfeeding, engaging in outdoor activities, and exposure to sunlight are recommended to promote the body’s own synthesis of vitamin D. Regular physical examinations are also advised, and if symptoms of rickets occur, an appropriate increase in vitamin D intake may be necessary.
Is rickets easy to treat?
Rickets is primarily a nutritional disease caused by insufficient levels of vitamin D leading to disturbances in calcium and phosphate metabolism, resulting in abnormal bone development. The most common type is nutritional vitamin D-deficiency rickets. This type of disease is self-limiting and thus relatively easy to treat. It requires early detection and proactive intervention. Early measures include encouraging children to engage in outdoor activities and supplementing with appropriate doses of vitamin D, which can effectively treat rickets. However, there are also special causes of vitamin D deficiency such as significant anomalies in liver or kidney function and certain genetic diseases that severely impair vitamin D absorption. When vitamin D treatment is ineffective, it may be due to other special causes. Treatment of rickets under these circumstances can be more challenging, and genetic diseases may respond poorly to treatment.
What are the symptoms of rickets?
The condition generally referred to as rickets is most commonly nutritional vitamin D deficiency rickets, a type of nutritional disease that is prevalent among infants and young children, particularly very young babies. It primarily manifests as changes in the bones where growth is most rapid and can also affect muscle development and changes in nervous excitability. Initially, especially within the first three months, symptoms in very young infants typically include increased nervous excitability, such as crying easily, excessive head sweating, and as a result of the sweating, frequent head shaking, irritability, restlessness, and noticeable crying and restlessness at night. These symptoms at this stage are not necessarily indicative of typical rickets. As the condition progresses, changes in the skeleton gradually become apparent. In infants under six months with rickets, the changes are mainly in the skull, typically feeling like pressing on a ping-pong ball. After six months of age, the head shape becomes squared or box-like, and the head circumference is larger than normal. Later, the characteristic beading changes of rickets appear, with beaded protrusions above the ribs, followed by the formation of blunt, circular raised areas at the wrists and ankles, referred to as wrist and ankle bracelets. Around the age of one, infants may develop a deformity resembling pigeon chest. As the child begins to stand and walk, the weight bearing on the lower limbs may lead to deformities, such as bowlegs or knock-knees, and sometimes even K-shaped deformities of the legs, and some might develop spinal deformities.
What foods should not be eaten with rickets?
Patients with rickets should not eat some cereal foods, such as millet, rice, wheat, corn, and other foods. Cereal foods also contain vitamin D and calcium, and eating too much of these foods can exacerbate the disease. Patients with rickets should eat more light, low-fat, and easily digestible foods. They should control the intake of high-fat content daily and avoid eating stimulating and spicy foods. At the same time, they should increase their intake of vitamins, encourage the child to eat more fruits and vegetables to ensure an adequate supply of vitamins, and patients can also exercise more. More physical activity can help boost the immune system.
Symptoms of rickets in infants and young children
The symptoms of rickets in infants and young children mainly include excessive sweating, night terrors, thinning hair at the back of the head, rib cage flaring, pigeon chest, bow legs, and knock knees, among others. If a child exhibits the above symptoms, it is necessary to promptly test for trace elements and check bone density to see if the child has symptoms of calcium deficiency. If so, it is crucial to supplement the child with vitamin D and calcium. In terms of diet, it is necessary to enhance the child's nutrition and increase outdoor activities. Ensure that the child engages in outdoor activities for more than two hours each day, particularly between 12 PM and 2 PM. Avoid exposing the child to sunlight during this time to prevent sunburn, especially to the child's eyes.
Can rickets be treated with vitamin D3?
Rickets can be treated with Vitamin D3; first, we need to understand the pathology of the disease. It is a metabolic, obstructive disease caused by a deficiency of Vitamin D. Often, this deficiency leads to impaired calcium absorption in the body, causing osteoporosis and bone deformity. Infants typically exhibit symptoms like square skulls, pigeon chests, outward flaring ribs, bow legs, and knock knees. Additionally, it affects the baby's sleep quality. The lack of Vitamin D can increase the baby's neural excitability, leading to poor sleep and easy waking. Moreover, severe cases can affect growth and development. Presence of these symptoms should be confirmed by laboratory testing of 25-hydroxy Vitamin D3 to determine specific levels and choose the appropriate dose of Vitamin D3 supplementation. It is also encouraged to promote children's physical activity and exposure to sunlight to enhance the body's synthesis of Vitamin D, which is beneficial for bone development. (Medication should be administered under the guidance of a professional doctor.)
What is the treatment method for rickets?
Rickets is primarily caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal skeletal development—a type of systemic nutritional disease. The most common form is nutritional rickets due to a deficiency in nutrients and vitamin D. Treatment focuses on controlling the active phase to prevent relapse of deformities. Therefore, early detection and comprehensive treatment are crucial. The primary treatment method involves supplementing with vitamin D. The choice of vitamin D, the dosage, and the length of treatment generally need to be tailored to the specific circumstances of the child. Additionally, increased exposure to sunlight and appropriate outdoor activities should be encouraged to enhance the absorption of vitamin D. Children should also be supplemented with calcium and a variety of vitamins. Follow-ups during the recovery phase are necessary, and training in sitting, standing, and walking should not be started too early to avoid deformities in the lower limbs. Furthermore, no medication is needed during the residual stage of the disease. For mild to moderate cases, physical exercise should be intensified, and skeletal deformities can be corrected using active or passive exercises. Severe skeletal deformities may require surgical correction.
The difference between rickets and dwarfism.
Rickets is caused by a deficiency of vitamin D in infants and young children, leading to disturbances in calcium and phosphorus metabolism and resulting in skeletal abnormalities as a characteristic of this chronic nutritional disease. Typical symptoms can include changes in the bones, especially in the fastest growing parts of the skeleton, and can affect muscle development and changes in neural excitability. Symptoms such as a "ping pong ball" head, square skull, pigeon chest, funnel chest, and eversion of the rib margins are also observed. Diagnosis is made through examinations such as vitamin D levels and skeletal X-rays. Dwarfism, on the other hand, is a growth disorder caused by a deficiency of growth hormone from the anterior pituitary gland before puberty. Its clinical manifestations are primarily growth disturbances, characterized by a short, proportionate stature. Adults with this condition often retain a child-like appearance, and their bone development is delayed with bone age younger than their chronological age. Intellect corresponds to their age, and sexual development may also be disrupted.
Why does rickets cause sweating?
Rickets is a chronic, nutritional disease characterized by skeletal lesions due to a deficiency of vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism. It is primarily caused by a lack of vitamin D, which can increase neural excitability. Research shows that the vitamin D metabolite, 1,25-dihydroxyvitamin D3, is not only an essential nutrient but also a precursor to hormones. It is potentially related to various cells including those in the thyroid, pancreas, stomach, brain, and those involved with calcium balance, as well as the immune, endocrine, reproductive systems, skin, and tumors. A deficiency in vitamin D can increase myocardial excitability and lead to symptoms like excessive sweating.
Nursing Measures for Children with Rickets
Rickets requires relevant home care. During the active phase of rickets, it is best to avoid early sitting, standing, and walking. For chest deformities, prone neck lifting and chest expansion exercises can be performed. For lower limb deformities, muscle massage can be done. For bow legs, massage the outer leg muscles and perform abductive and external rotation exercises after massaging both knee joints. For knock knees, massage the inner muscle group and perform internal rotation exercises after massaging both ankle joints. For posterior protrusion of the lumbar spine, massage the lumbosacral area and frequently lie prone to increase muscle tone, assisting in the recovery of deformities. For mild to moderate bow legs, it may be appropriate to slightly elevate the outside of the shoe by about 0.5 cm. For mild to moderate knock knees, it may be appropriate to slightly elevate the inside of the shoe by about 0.5 cm. Observe for one to three months and adjust the padding height as necessary, which generally can correct the condition. Additionally, children should be exposed to more outdoor sunlight and have a rich nutritional intake, including nutrient-rich proteins and dairy products to aid in recovery from the disease.