Rickets and osteoporosis are caused by a lack of what?

Written by Zeng Hai Jiang
Pediatrics
Updated on March 05, 2025
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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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What department should I go to for rickets?

Rickets, called nutritional vitamin D deficiency rickets, is a chronic systemic nutritional disease characterized by bone lesions, caused by a lack of vitamin D in children's bodies leading to disturbed calcium and phosphorus metabolism. Its typical manifestations are inadequate mineralization of the growing long bone shafts and bone tissue. In early-stage rickets, there are no obvious skeletal changes, primarily characterized by low levels of vitamin D and abnormal calcium and phosphorus metabolism, in which case consultation with a pediatric endocrinologist is advised. If evident skeletal deformities like pigeon chest, X-shaped legs, or O-shaped legs have already developed, corrective treatment is necessary, and an orthopedic consultation is required.

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Written by Mo Ming Hua
Pediatrics
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If rickets is not treated, what will be the impact?

Rickets, if untreated, mainly involves changes in skeletal deformities and motor function in children. Rickets is primarily caused by a deficiency in vitamin D, which is essential for promoting the absorption of calcium. A deficiency in vitamin D leads to reduced calcium absorption. Lower calcium absorption results in a calcium deficiency in the body, which in turn causes changes in the bones. In the early stages of vitamin D deficiency, the main symptoms are increased neural excitability, which may manifest as startle reactions, irritability, restlessness, and excessive sweating. During the active phase, symptoms of increased nervous system excitability become more pronounced, mainly presenting as skeletal deformities. What aspects do these skeletal deformities affect? One is the softening of the skull, pigeon chest, funnel chest, and changes resembling wristbands and anklets. If the condition worsens further, it can present as X-shaped legs, O-shaped legs, and spinal deformities. Thus, if rickets progresses, it can lead to skeletal deformities and impairments in motor functions, among other issues.

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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 Zhang Xian Hua
Pediatrics
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Is pillow baldness rickets?

Balding at the back of the head is a common clinical manifestation of rickets, but it does not mean that balding at the back of the head is equivalent to rickets, as there are many causes for this condition. In children with rickets, due to a lack of vitamin D leading to calcium deficiency, their neural excitability increases, which can affect the baby's sleep and cause restless sleep leading to balding at the back of the head. However, children who are in poor nutritional condition might also experience deficiencies in trace elements, such as a lack of zinc or iron, which can also lead to sleep disturbances and balding at the back of the head, indicating that the cause may not necessarily be rickets. Additionally, a small number of children might have an inherent condition of increased neural excitability that affects sleep, leading to balding at the back of the head, which also isn't due to rickets. Therefore, if balding at the back of the head occurs, it is advisable to visit a hospital’s pediatric healthcare department or pediatric outpatient clinic for a consultation and check-up, to actively treat and manage based on the underlying cause.

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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.