What Is Rickets?

Rickets is a condition in children which involves softening of the bones which may eventually lead to fractures and deformity. Though it can also occur in adults (the term for which is called Osteomalacia), majority of rickets cases occur in children suffering from sever malnutrition as a result of famine or starvation during the early stages of childhood.

Causes of Rickets

Although inadequate calcium in the diet may cause rickets, the predominant cause is vitamin D deficiency. Vitamin D is necessary for proper calcium absorption. A lack in vitamin D will result in hypocalcemia or the presence of low serum calcium levels in the blood, which may then lead to skeletal deformities.

Who are at a higher risk for developing rickets?

Those are at a higher risk for developing rickets include: breast-fed infants whose mothers are not exposed to sunlight; breast-fed infants who are not exposed to sunlight; infants and individuals who do not consume fortified milk – for instance, those who are lactose intolerant.

There has been speculation involving red haired people having a decreased risk for rickets due to their greater production of vitamin D when exposed to sunlight.

Signs and Symptoms of rickets

An individual with rickets may have the following symptoms:

Bone pain or tenderness, dental problems, muscle weakness ( rickety myopathy or "floppy baby syndrome"), increased tendency for fractures especially green stick fractures, skeletal deformity, growth disturbance, hypocalcemia, tetany (uncontrolled muscle spasms all over the body), craniotabes (soft skull), costochondral (swelling or "rickety rosary), Harrison’s groove, double malleoli sign due to metaphysical hyperplasia.

In toddlers: they may have bowed legs (genu varum). In older children: Knock-knees (genu valgum) or "windswept knees", Cranial, spinal, and pelvic deformities.

In an x-ray, an advanced sufferer of rickets may show the following (classic) traits: bow legs, deformed chest, square appearance of the skull.

Diagnosis of rickets

To diagnose rickets, your doctor may conduct a blood test to check for the following: low serum calcium levels, low serum phosphorous levels, high serum alkaline phosphates, and metabolic acidosis in arterial blood gases.

An x-ray may be required to check for affected bones. Affected bones show calcium loss and changes in the shape or structure.

A bone biopsy may be preformed, though it this quite rare. Bone biopsy can confirm rickets.

Prevention and Treatment of rickets

To treat rickets, changes in diet and lifestyle is necessary. An individual with rickets should have an increased dietary intake of calcium, phosphates and vitamin D. Good sources of vitamin D include: ultraviolet rays (sunlight), cod liver oil, halibut-liver oil and viosterol. In therapy, the replacement of vitamin D is proven to correct rickets. Treatment methods include ultraviolet light therapy and medication.

To prevent rickets, it is necessary to receive a sufficient amount of sunlight, a diet rich in calcium, vitamin D and phosphorous. Keep in mind though, that dark skinned babies and individuals need to be exposed longer to UV rays.

It is recommended that infants and children receive 200 international units (IU) of vitamin D per day. Adequate vitamin D may be achieved from taking dietary supplements. Vitamin D3 is preferred because it is more readily absorbed than vitamin D2.

Dermatologist recommends vitamin D supplements to unprotected exposure to UV rays, as this may lead to an increased risk of skin cancer.

The American Academy of Pediatrics recommend that exclusively breast-fed infants should receive daily supplements of vitamin D from age 2 months (until they begin drinking at least 17 ounces of vitamin D-fortified milk daily), since they might not get adequate vitamin D from breast milk alone.


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