Rickets: Causes, Symptoms and Treatments
Kalyan nagar, Bengaluru Feb 14, 2017
It is a skeletal disorder that is caused by a lack of vitamin D, calcium, or phosphate. These nutrients are important for the development of strong, healthy bones. People with rickets may have weak and soft bones, stunted growth, and, in severe cases, skeletal deformities. It is unique to children and adolescents.
The cause is always either due to a deficiency of vitamin D, calcium, or phosphate. Three common causes of rickets include nutritional rickets, hypophosphatemic rickets, and renal rickets.
It is also called osteomalacia, is a condition caused by vitamin D deficiency. It is essential for normal formation of bones and teeth and necessary for the appropriate absorption of calcium and phosphorus from the bowels.
It is caused by chronically low levels of phosphate in the blood. The bones become painfully soft and pliable. This is caused by a genetic dominant X-linked defect in the ability of the kidneys into the urine. This is not caused by a vitamin D deficiency. Patients with this type of rickets typically have obvious symptoms by 1 year of age.
It is caused by a number of kidney disorders. Individuals suffering from kidney disease often have decreased the ability to regulate the amounts of electrolytes lost in the urine. This includes calcium and phosphate, and therefore the affected individuals develop symptoms almost identical to severe nutritional rickets.
Symptoms and signs
Symptoms include bone pain or tenderness, dental deformities, delayed formation of teeth, decreased muscle strength, impaired growth, short stature, and a number of skeletal deformities, including an abnormally shaped skull, bowlegs, rib-cage abnormalities, and breastbone, pelvic, and spinal deformities.
It is diagnosed clinically with a complete medical and nutritional history and with a complete physical exam by a health professional. If rickets is suspected in a child and the child has no acute symptoms such as seizures or tetany, X-rays of long bones and ribs are obtained.
The following tests may help diagnose rickets:
- Arterial blood gases
- Blood tests
- Bone biopsy
- Bone X-rays
- Serum alkaline phosphatase (ALP)
- Serum Phosphorus
- ALP isoenzyme
- Calcium test
- PTH test
- Urine calcium
In case of nutritional rickets and vitamin D deficiency, treatment is simple. The first step is to prevent the complications of calcium and phosphate deficiency by correcting any abnormal levels with supplemental calcium or phosphate deficiency by correcting any abnormal levels with supplemental calcium or phosphate as well as the activated vitamin D.
Paediatricians, family practitioners, and obstetricians are responsible for educating parents about measures to prevent rickets. For the expecting mother, this includes recommending prenatal vitamins and appropriate nutritional counselling.