Early clinical manifestations of rickets

Written by Li Jiao Yan
Neonatology
Updated on September 05, 2024
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Early Symptoms of Rickets:

Rickets is a chronic nutritional disease caused by a deficiency in Vitamin D, leading to disordered calcium and phosphorus metabolism and resulting in abnormal skeletal development. It primarily affects infants, especially those under six months old, with the highest occurrence in infants under three months. The general symptoms include heightened neural excitability, such as fussiness, easy irritability, sudden bouts of crying, or being so sensitive that they cry when touched. Other symptoms include excessive sweating and frequent head shaking, though these are not specific indicators of rickets.

Diagnosis mainly relies on biochemical markers and Vitamin D levels, like decreased blood calcium and phosphorus levels, elevated parathyroid hormone levels, and reduced 25-hydroxy-D3. X-ray images of bones might appear normal.

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Written by Li Jiao Yan
Neonatology
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How should children with rickets supplement calcium?

Rickets is a nutritional disease caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal bone development. It is mainly due to a lack of vitamin D, so the primary treatment is supplementing with vitamin D. Dairy is a reliable source of calcium nutrition for infants, and generally, it is not necessary to supplement calcium for the treatment of rickets; attention should be paid to supplementing with vitamin D according to the severity of the condition, and spending more time in the sun. For children who have started eating complementary foods, or older children, it is generally recommended to fully supplement vitamin D levels, spend more time in the sun during summer, and consume high-protein nutrients. Additionally, eating more vegetables and appropriately supplementing with calcium supplements in the winter is advised. The dosage should be based on the child's internal levels of calcium and phosphorus, with calcium supplementation adjusted accordingly.

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Written by Zeng Hai Jiang
Pediatrics
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Rickets and osteoporosis are caused by a lack of what?

Rickets and osteoporosis are both caused by a lack of vitamin D and calcium. Rickets is commonly seen in infants and can present with abnormalities in skeletal development such as "ping-pong ball head", signs of wrist and ankle bracelets, square skull, funnel chest, pigeon chest, X-shaped legs, and O-shaped legs. Osteoporosis is a metabolic bone disease caused by reduced bone formation and increased bone resorption. It can be categorized according to its etiology into senile osteoporosis, postmenopausal osteoporosis, idiopathic osteoporosis, and secondary osteoporosis. Clinically, it can manifest as fatigue, bone pain, and fractures.

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Written by Li Jiao Yan
Neonatology
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How to treat rickets X-type legs?

If rickets presents with an X-shaped deformity, it generally indicates either an active phase of the disease or the residual phase. During this time, it is advisable to minimize the child's standing and walking at home. For lower limb deformities, muscle massages can be performed. For X-shaped legs, massage the inner muscle groups, followed by internal rotation exercises after massaging the double sliding joints. Typically, early treatment involves corrective rehabilitation techniques, and it is possible to visit a pediatric rehabilitation department for relevant manual treatments. If there is a significant skeletal deformity, surgical intervention may be necessary for correction.

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Written by Li Jiao Yan
Neonatology
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How to diagnose rickets?

Rickets is caused by a deficiency of vitamin D, which leads to abnormal calcium and phosphorus metabolism, and thus abnormal bone development. Generally, rickets requires biochemical blood tests and vitamin D level assessments, followed by skeletal X-ray examinations. However, some cases of rickets are caused by other special reasons, such as abnormalities in liver and kidney functions, and there may also be congenital genetic diseases. Therefore, rickets also requires further related examinations, such as liver function tests, kidney function tests, and parathyroid hormone tests, and even some genetic level examinations might be conducted.

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Written by Yao Li Qin
Pediatrics
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Clinical manifestations of rickets

Rickets, also known as vitamin D deficiency rickets, occurs because children do not supplement vitamin D in a timely manner after birth, leading to a deficiency of vitamin D in the body and resulting in a nutritional metabolic disease primarily involving skeletal changes. In the early stages, children mainly show symptoms related to mental and emotional state, such as irritability, crying, excessive sweating, shaking their heads back and forth, and rubbing their heads. Subsequently, symptoms like bald patches on the back of the head and softening of the skull bones may appear. As children grow, they may develop conditions such as a square-shaped skull, beaded ribs, pigeon chest, funnel chest, and bracelet-like deformities around the wrists and ankles. In severe cases, children may later develop X-shaped legs and O-shaped legs. If rickets is suspected, it is crucial to promptly conduct a blood test to measure the vitamin D level. If the level is below normal, it is essential to actively treat the diagnosed rickets.