What department should I go to for rickets?

Written by Li Jiao Yan
Neonatology
Updated on September 15, 2024
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Rickets, called nutritional vitamin D deficiency rickets, is a chronic systemic nutritional disease characterized by bone lesions, caused by a lack of vitamin D in children's bodies leading to disturbed calcium and phosphorus metabolism. Its typical manifestations are inadequate mineralization of the growing long bone shafts and bone tissue. In early-stage rickets, there are no obvious skeletal changes, primarily characterized by low levels of vitamin D and abnormal calcium and phosphorus metabolism, in which case consultation with a pediatric endocrinologist is advised. If evident skeletal deformities like pigeon chest, X-shaped legs, or O-shaped legs have already developed, corrective treatment is necessary, and an orthopedic consultation is required.

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Written by Li Jiao Yan
Neonatology
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How is rickets treated?

How is rickets treated? Rickets is caused by a lack of vitamin D, leading to disturbances in calcium and phosphorus metabolism. The common nutritional deficiency of vitamin D, primarily due to insufficient intake, results in abnormal bone development. At this time, effectively supplementing vitamin D, engaging in appropriate outdoor activities, and receiving ample sunlight can treat rickets in children. However, there are some special cases, such as significant abnormalities in liver or kidney function, where treatment should be targeted based on the cause of the condition. In addition, some congenital genetic abnormalities causing disturbances in calcium and phosphorus metabolism can make treatment more challenging. Therefore, the treatment of rickets should be based on specific conditions. Generally, if it is simply a case of nutritional deficiency of vitamin D, the treatment outcome is quite favorable and the condition is considered self-limiting. Thus, if a vitamin D deficiency is detected, it is important to supplement promptly to prevent further abnormal bone development.

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Written by Li Jiao Yan
Neonatology
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Rickets symptoms

Rickets, also known as nutritional vitamin D deficiency rickets, is a chronic nutritional disease in children caused by inadequate vitamin D in their bodies, leading to disorders in calcium and phosphorus metabolism and characterized by changes in the growth plates. Its manifestation varies with different ages. In infants under six months, especially those under three months, symptoms often include increased nervous excitability, such as being easily irritable, restless, sweating, and shaking their heads due to scalp irritation. As the condition progresses in children under six months, the primary changes are seen in the skull; the edges of the anterior fontanelle are softer, and the skull is thinner. After six months, the softening of the skull disappears, but there can be ping-pong ball-like changes around the skull, leading to a box-shaped head from seven to eight months. Gradually, beading changes form, most notably around the 7th to 10th ribs. Around the age of one, children can develop a pigeon chest deformity, and in severe cases of rickets, a horizontal depression forms at the lower edge of the thoracic cage, known as the costal groove or Harrison's groove. Due to bone softening and muscle and joint laxity, when the child begins to stand and walk, the legs may become bow-legged or X-shaped, and in severe cases, can develop into 'K'-shaped leg deformities. Once the child starts to sit and stand, general ligament laxity can cause spinal deformities. Severe hypophosphatemia leads to muscle carbohydrate metabolism disorder, resulting in overall muscle laxity, decreased muscle tone, and subsequently reduced muscle strength.

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Written by Mo Ming Hua
Pediatrics
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If rickets is not treated, what will be the impact?

Rickets, if untreated, mainly involves changes in skeletal deformities and motor function in children. Rickets is primarily caused by a deficiency in vitamin D, which is essential for promoting the absorption of calcium. A deficiency in vitamin D leads to reduced calcium absorption. Lower calcium absorption results in a calcium deficiency in the body, which in turn causes changes in the bones. In the early stages of vitamin D deficiency, the main symptoms are increased neural excitability, which may manifest as startle reactions, irritability, restlessness, and excessive sweating. During the active phase, symptoms of increased nervous system excitability become more pronounced, mainly presenting as skeletal deformities. What aspects do these skeletal deformities affect? One is the softening of the skull, pigeon chest, funnel chest, and changes resembling wristbands and anklets. If the condition worsens further, it can present as X-shaped legs, O-shaped legs, and spinal deformities. Thus, if rickets progresses, it can lead to skeletal deformities and impairments in motor functions, among other issues.

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Written by Li Jiao Yan
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Can rickets be cured?

The rickets we commonly talk about is nutritional Vitamin D deficiency rickets, which is due to a deficiency of Vitamin D in the body leading to a disorder of calcium and phosphorus metabolism. This results in a systemic nutritional disease characterized by skeletal lesions. If rickets is caused by insufficient intake, it can be self-healing and is a self-limiting disease. Once infants and young children spend enough time outdoors and receive physiological doses of Vitamin D treatment, rickets can be treated. However, treatment becomes significantly challenging in cases of congenital developmental abnormalities causing skeletal lesions, or any genetic diseases that lead to Vitamin D absorption disorders. Such cases often result in severe complications, including prominent kidney dysfunction leading to further disturbances in calcium and phosphorus metabolism, as well as liver function abnormalities causing Vitamin D synthesis disorders. Therefore, it is important to understand the specific causes of Vitamin D deficiency in children, and if the deficiency is due to common reasons that can be promptly controlled, then supplementation with Vitamin D and trace elements like calcium can effectively treat the condition.

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Written by Li Jiao Yan
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Can rickets be cured?

Rickets refers to a nutritional disease characterized by bone lesions caused by disorders in calcium and phosphorus metabolism due to a deficiency of vitamin D in the body. The primary treatment for rickets involves early detection and comprehensive treatment at an early stage, which is crucial. The general treatment goal is to control the active phase, prevent deformities, and avoid recurrence. Nutritional rickets due to a deficiency of vitamin D is a self-limiting disease; it can be cured once infants and young children engage in sufficient outdoor activities and supplement with vitamin D. Early detection of low vitamin D levels or abnormalities in calcium and phosphorus metabolism, along with early proactive intervention, can prevent the occurrence of skeletal deformities. If sequelae are present, there is no need for medication; mild to moderate cases should strengthen physical exercise, and skeletal deformities can be corrected through active or passive rehabilitation movements. Severe skeletal deformities can be corrected through surgical treatment.