Early symptoms of rickets

Written by Li Jiao Yan
Neonatology
Updated on September 20, 2024
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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 Yao Li Qin
Pediatrics
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The main manifestations of rickets in the early stage

Rickets generally refers to vitamin D deficiency rickets, mainly due to insufficient vitamin D in children, leading to calcium and phosphorus metabolism disorders. It is a chronic nutritional disease characterized by skeletal lesions. The main manifestations are changes in the fastest growing parts of the skeleton, which can also affect muscle development and changes in neural excitability. The initial symptoms of rickets are common in infants, especially those under three months old. The main symptom is increased neural excitability; the child is particularly prone to being agitated, irritable, crying, sweating, and shaking their head due to scalp stimulation, but these are not specific symptoms of rickets. Therefore, blood tests are still necessary in the early stages, showing decreased levels of 25-hydroxyvitamin D3, blood calcium, and blood phosphate, increased PTH, normal or slightly elevated alkaline phosphatase activity, and normal or slightly blurry calcification zones in skeletal X-rays. These are the early manifestations of rickets.

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Written by Yao Li Qin
Pediatrics
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How is rickets treated with injections?

Rickets, also known as vitamin D deficiency rickets, is a chronic nutritional disease characterized by skeletal lesions, caused by insufficient vitamin D in children, leading to disturbances in calcium and phosphorus metabolism. The typical manifestation of rickets is incomplete mineralization of the growing long bone epiphyses and bone tissue, presenting as bone softening or deformity. Once rickets is diagnosed, it must be treated aggressively. First, children are given high doses of vitamin D, either orally or through intramuscular injection, with a common practice of administering a single dose of 300,000 units of vitamin D intramuscularly. A month later, a blood sample is taken to measure the vitamin D content; if it is below normal, treatment must continue; if it is within the normal range, it is only necessary to supplement the daily physiological requirement of vitamin D for the child. (Specific medication should be administered under the guidance of a physician.)

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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 Li Jiao Yan
Neonatology
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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.

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Written by Zeng Hai Jiang
Pediatrics
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Is a square skull definitely rickets?

Square skull is not necessarily rickets; square skull can be seen in rickets and congenital syphilis, especially common in rickets. It is often seen in children with rickets older than 8-9 months, due to a lack of calcium in the bones which leads to inadequate bone deposition and calcification. Under the periosteum of the child's frontal bone, parietal bone, and occipital bone, a large amount of osteoid deposition forms the square skull. Therefore, while square skull is not necessarily indicative of rickets, it is a common manifestation in rickets.