How is rickets treated?

Written by Li Jiao Yan
Neonatology
Updated on September 13, 2024
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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 Yao Li Qin
Pediatrics
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Causes of Rickets

Rickets, also known as Vitamin D-deficiency rickets, implies from its name that the cause of the disease is due to insufficient intake of Vitamin D in children, leading to disorders in calcium and phosphorus metabolism and resulting in nutritional disease with skeletal deformities. The incidence of the disease is higher in the north than in the south. Currently, the incidence of mild and moderate rickets is relatively high, while severe cases are less common because people are increasingly paying attention to the supplementation of Vitamin D for children. It is recommended that full-term infants start supplementing with 400 units of Vitamin D daily two weeks after birth, which is the physiological requirement. For premature infants, twins, and extremely low birth weight infants, the daily physiological requirement of supplementation is 800 units per day. After supplementing continuously for three months, it should be adjusted to 400 units per day as per the requirement for full-term infants. With such management, the child will not suffer from rickets. However, if there is no regular supplementation after birth, the lack of Vitamin D can lead to skeletal changes in the child, and once rickets is diagnosed, it requires high doses of supplementation.

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Written by Tong Peng
Pediatrics
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Will rickets lead to hunchback when grown up?

Rickets generally does not result in hunchback when one grows up, as rickets is a disease caused by a vitamin D deficiency leading to disturbances in calcium and phosphorus metabolism. If not cured before development is completed, it often leaves sequelae such as square skull, Harrison's groove, beaded ribs, as well as bow legs, knock knees, and pigeon chest. However, hunchback is mainly caused by developmental deformities of the thoracic and lumbar spine, and is not greatly related to a lack of vitamin D. However, it is also important to note that a deficiency in vitamin D can lead to osteoporosis, and if one does not maintain proper posture in daily life, such as bending the back while sitting, standing, or walking and not being able to stand straight, it may eventually lead to pathological curvature of the spine and thoracic vertebrae. Therefore, in daily life, it is still important to be conscious of using one’s lumbar and thoracic spine correctly to avoid developing a hunchback over time.

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Written by Li Jiao Yan
Neonatology
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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.

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Written by Zeng Hai Jiang
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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.

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Written by Li Jiao Yan
Neonatology
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What department should I go to for rickets?

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.