How is rickets diagnosed?

Written by Li Jiao Yan
Neonatology
Updated on September 14, 2024
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Rickets is a chronic nutritional disease characterized by skeletal changes, resulting from insufficient Vitamin D in children, which leads to disruptions in calcium and phosphorus metabolism. Diagnosis of rickets requires a measure of Vitamin D levels, clinical manifestations, certain biochemical markers in blood, and skeletal X-ray findings. Typically, Vitamin D levels are significantly lower than usual, with the level of 25-hydroxyvitamin D3 being the most reliable diagnostic standard. However, many facilities are unable to perform this test, so some instead rely on blood biochemistry and skeletal X-rays. Currently, blood biochemistry and skeletal X-ray examinations are considered the gold standard for diagnosis.

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Written by Huang Kun Mei
Pediatrics
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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.

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Written by Tong Peng
Pediatrics
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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.

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Written by Li Jiao Yan
Neonatology
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Rickets Causes

Rickets, fully termed as nutritional vitamin D deficiency rickets, is a chronic systemic nutritional disease characterized by epiphyseal lesions, caused by insufficient vitamin D in children, leading to disordered calcium and phosphate metabolism. The main causes of the disease include insufficient perinatal vitamin D, particularly during the prenatal and postnatal periods, as well as factors like severe maternal malnutrition, liver and kidney diseases, chronic diarrhea, prematurity, and having twins, which may lead to inadequate levels of vitamin D storage in the body. Additionally, insufficient sunlight exposure, such as children spending prolonged periods indoors, blocks sunlight, as ultraviolet rays cannot pass through glass. Ultraviolet light aids in the synthesis of endogenous vitamin D; lack of exposure can also reduce vitamin D levels. Another factor is rapid growth rates, and fourthly, insufficient dietary supplementation of vitamin D along with some diseases that affect the absorption of vitamin D, like gastrointestinal or liver and biliary diseases.

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Written by Li Jiao Yan
Neonatology
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Early symptoms of rickets

Rickets is a chronic nutritional disease primarily caused by a deficiency of Vitamin D, which leads to disturbances in calcium and phosphorus metabolism in the body, resulting in abnormal bone development. It is mostly seen in infants, especially common within the first six months, and particularly in babies younger than three months. Clinically, the symptoms are not very specific; the children may appear irritable and restless, they might cry suddenly, or become agitated and restless to the touch. Some children may exhibit excessive sweating, frequent head shaking, or even hair loss, leading to noticeable baldness at the back of the head. However, these symptoms are not very specific. Generally, blood biochemistry and Vitamin D levels need to be tested. Early X-ray findings of the bones can be normal.

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Written by Li Jiao Yan
Neonatology
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Rickets is a deficiency of what?

Rickets is caused by a deficiency of what? For rickets, its main gold standard for diagnosis is based on the results of blood biochemistry and skeletal X-ray examinations. Generally, the deficiency in rickets is mainly due to insufficient levels of vitamin D, which then leads to disturbances in calcium and phosphorus metabolism. Typically, this is characterized by low levels of 25-hydroxyvitamin D3 in the body, along with decreased levels of blood calcium and phosphorus, manifesting as deficiencies in calcium, phosphorus, and vitamin D. However, in children, rickets could also be caused by other factors, such as abnormalities in liver or kidney function, or congenital hereditary diseases. Generally, further tests are needed to confirm rickets. If other special causes are ruled out, timely supplementation of vitamin D and appropriate exposure to sunlight, along with calcium supplementation, can effectively cure the disease.