What are the symptoms of rickets?

Written by Li Jiao Yan
Neonatology
Updated on December 08, 2024
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The condition generally referred to as rickets is most commonly nutritional vitamin D deficiency rickets, a type of nutritional disease that is prevalent among infants and young children, particularly very young babies. It primarily manifests as changes in the bones where growth is most rapid and can also affect muscle development and changes in nervous excitability. Initially, especially within the first three months, symptoms in very young infants typically include increased nervous excitability, such as crying easily, excessive head sweating, and as a result of the sweating, frequent head shaking, irritability, restlessness, and noticeable crying and restlessness at night. These symptoms at this stage are not necessarily indicative of typical rickets.

As the condition progresses, changes in the skeleton gradually become apparent. In infants under six months with rickets, the changes are mainly in the skull, typically feeling like pressing on a ping-pong ball. After six months of age, the head shape becomes squared or box-like, and the head circumference is larger than normal. Later, the characteristic beading changes of rickets appear, with beaded protrusions above the ribs, followed by the formation of blunt, circular raised areas at the wrists and ankles, referred to as wrist and ankle bracelets. Around the age of one, infants may develop a deformity resembling pigeon chest. As the child begins to stand and walk, the weight bearing on the lower limbs may lead to deformities, such as bowlegs or knock-knees, and sometimes even K-shaped deformities of the legs, and some might develop spinal deformities.

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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
Pediatrics
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The difference between rickets and rib flare

Rickets and rib flaring are different; rib flaring can be considered a symptom of rickets. Rickets is caused by a deficiency of vitamin D in infants and children, leading to abnormal metabolism of calcium and phosphorus, which results in incomplete calcification and softening of the bones, thereby causing skeletal deformities. Rickets can be divided into initial, active, recovery, and sequelae stages. During the active stage of rickets, skeletal deformities such as softened skull, "ping pong" head, square skull, rib flaring, pigeon chest, funnel chest, X-shaped legs, and O-shaped legs are prone to occur.

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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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Which department should I go to for rickets?

Rickets is a nutritional disease caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism and resulting in abnormal bone development. During the early and active stages, the X-ray shows no obvious abnormalities in bone development; it is primarily a conceptual metabolic disorder along with low levels of vitamin D. At this time, it is advisable to consult an endocrinology department. If there are sequelae and mild to moderate sequelae, rehabilitation methods are needed for correction, and at this point, a rehabilitation department should be consulted. If there are severe skeletal deformities, surgical correction may be necessary, and at this time, an orthopedic department should be consulted.

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Written by Li Jiao Yan
Neonatology
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How to treat rickets in a 2-year-old baby?

Rickets in two-year-old infants is caused by a deficiency in vitamin D leading to a disturbance in calcium and phosphorus metabolism, resulting in abnormal skeletal development. This class of systemic, chronic, nutritional diseases typically manifests in two-year-olds who are able to walk and stand. Due to the force of gravity, lower limb deformities may develop, leading to bowlegs or knock-knees, and possibly even a 'K'-shaped limb deformity. The spine may also develop kyphosis or scoliosis. Around the age of two, it is generally the residual stage of the disease, which often does not require pharmacological treatment. For mild to moderate cases, physical exercise should be enhanced, and active or passive rehabilitation methods should be used to correct skeletal deformities. It is recommended to seek treatment in the pediatric rehabilitation department; severe skeletal deformities may require surgical correction.