Rickets is a disease that affects bone development in children due to vitamin D deficiency, calcium, or phosphate. It is treatable with proper nutrition and supplementation.

Written by Li Jiao Yan
Neonatology
Updated on December 26, 2024
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Rickets, also known as vitamin D deficiency rickets, is caused by a lack of vitamin D, leading to abnormal calcium and phosphorus metabolism in the body. The calcium salts cannot be properly deposited in the growing parts of the skeleton, causing incomplete mineralization of the bone tissue during growth. This results in a chronic systemic nutritional disease closely related to lifestyle, characterized by skeletal abnormalities. The most common is nutritional vitamin D deficiency, which is self-limiting. Typically, sufficient vitamin D supplementation and appropriate sun exposure can cure it. If caused by other severe diseases, vitamin D deficiency will significantly manifest liver and kidney function abnormalities. Additionally, some congenital genetic diseases make treatment more difficult when vitamin D levels are deficient.

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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.

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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.

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Written by Li Jiao Yan
Neonatology
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What is the treatment method for rickets?

Rickets is primarily caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal skeletal development—a type of systemic nutritional disease. The most common form is nutritional rickets due to a deficiency in nutrients and vitamin D. Treatment focuses on controlling the active phase to prevent relapse of deformities. Therefore, early detection and comprehensive treatment are crucial. The primary treatment method involves supplementing with vitamin D. The choice of vitamin D, the dosage, and the length of treatment generally need to be tailored to the specific circumstances of the child. Additionally, increased exposure to sunlight and appropriate outdoor activities should be encouraged to enhance the absorption of vitamin D. Children should also be supplemented with calcium and a variety of vitamins. Follow-ups during the recovery phase are necessary, and training in sitting, standing, and walking should not be started too early to avoid deformities in the lower limbs. Furthermore, no medication is needed during the residual stage of the disease. For mild to moderate cases, physical exercise should be intensified, and skeletal deformities can be corrected using active or passive exercises. Severe skeletal deformities may require surgical correction.

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Written by Li Jiao Yan
Neonatology
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What are the symptoms of rickets?

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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How is rickets treated?

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.