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New page: Rickets is a disorder primarily caused by lack of vitamin D, calcium, or phosphate, which leads to softening and weakening of the bones. ==Causes, incidence, and risk factors== Vitamin D...
Rickets is a disorder primarily caused by lack of vitamin D, calcium, or phosphate, which leads to softening and weakening of the bones.
==Causes, incidence, and risk factors==
Vitamin D helps the body properly control calcium and phosphate levels in the body. When the body is deficient in vitamin D, it is unable to properly control calcium and phosphate levels. If the blood levels of these minerals become too low, the body may produce other body hormones to stimulate release of calcium and phosphate from the bones. This leads to weak and soft bones.
Vitamin D may be absorbed from food or may be produced by the skin when the skin is exposed to sunlight. Lack of vitamin D production by the skin may occur in people who must stay indoors, work indoors during the daylight hours, or live in climates with little exposure to sunlight.
Because vitamin D is a fat-soluble vitamin, malabsorption disorders that reduce digestion or absorption of fats will decrease the ability of vitamin D to be absorbed into the body.
Not getting enough calcium and phosphorous in your diet can also lead to rickets. Rickets caused by a dietary lack of these minerals is rare in developed countries because calcium and phosphorous are found in milk and green vegetables.
Genetics may increase the risk of rickets. Hereditary rickets is form of the disease that is passed down through families. It occurs when the kidneys are unable to retain the mineral phosphate. Rickets may also be caused by kidney disorders that involve renal tubular acidosis.
Rickets is rare in the United States. It is most likely to occur during periods of rapid growth, when the body demands high levels of calcium and phosphate. Rickets may be seen in young children 6 to 24 months old and is uncommon in newborns.
==Symptoms==
Bone pain or tenderness
Arms
Legs
Spine
Pelvis
Skeletal deformities
Bowlegs
Forward projection of the breastbone (pigeon chest)
Bumps in the rib cage (rachitic rosary)
Asymmetrical or odd-shaped skull
Spine deformities (spine curves abnormally, including scoliosis or kyphosis)
Pelvic deformities
Increased tendency toward bone fractures
Dental deformities
Delayed formation of teeth
Defects in the structure of teeth, holes in the enamel
Increased incidence of cavities in the teeth (dental caries)
Progressive weakness
Decreased muscle tone (loss of muscle strength)
Muscle cramps
Impaired growth
Short stature (adults less than 5 feet tall)
==Signs and tests==
A physical exam reveals tenderness or pain in the bones, rather than in the joints or muscles.
The following tests may help diagnose rickets:
:*Blood tests (serum calcium) may show low levels of calcium.
:*Tetany (prolonged muscle spasm) may occur if serum levels of calcium are low.
:*Chvostek's sign may be positive (a spasm of facial muscles occurs when the facial nerve is tapped) indicating low serum levels of calcium.
:*Serum phosphorus may be low.
:*Serum alkaline phosphatase may be high.
:*Arterial blood gases may reveal metabolic acidosis.
:*Bone x-rays may show loss of calcium from bones or changes in the shape or structure of the bones.
:*A bone biopsy is rarely performed but will confirm rickets.
Other tests and procedures include the following:
:*PTH
:*Urine calcium
:*Calcium (ionized)
:*ALP (alkaline phosphatase) isoenzyme
==Treatment==
The treatment goals are to relieve symptoms and correct the cause of the condition. The underlying cause must be treated to prevent recurrence.
The replacement of deficient calcium, phosphorus, or vitamin D will eliminate most symptoms of rickets. Dietary sources of vitamin D include fish, liver, and processed milk. Exposure to moderate amounts of sunlight is encouraged. Treating rickets caused by metabolic abnormalities may require a special prescription for vitamin D.
Positioning or bracing may be used to reduce or prevent deformities. Some skeletal deformities may require corrective surgery.
==Expectations (prognosis)==
The disorder may be corrected with replacement of deficient minerals and vitamin D. Laboratory values and x-rays usually improve after about 1 week, although some cases may be resistant and require large doses of minerals and vitamin D.
If rickets is not corrected while children are still growing, skeletal deformities and short stature may be permanent. If it is corrected while the child is young, skeletal deformities often diminish or disappear with time.
==Complications==
Chronic skeletal pain
Skeletal deformities
Skeletal fractures, may occur without cause
Calling your health care provider
==Prevention==
Rickets may be avoided by maintaining an adequate intake of calcium, phosphorus, and vitamin D.
Renal (kidney) causes of vitamin D malabsorption should be treated promptly. Levels of calcium and phosphorus should be monitored regularly in people who have renal disorders.
Genetic counseling may help people with a family history of inherited disorders that can cause rickets.
==Causes, incidence, and risk factors==
Vitamin D helps the body properly control calcium and phosphate levels in the body. When the body is deficient in vitamin D, it is unable to properly control calcium and phosphate levels. If the blood levels of these minerals become too low, the body may produce other body hormones to stimulate release of calcium and phosphate from the bones. This leads to weak and soft bones.
Vitamin D may be absorbed from food or may be produced by the skin when the skin is exposed to sunlight. Lack of vitamin D production by the skin may occur in people who must stay indoors, work indoors during the daylight hours, or live in climates with little exposure to sunlight.
Because vitamin D is a fat-soluble vitamin, malabsorption disorders that reduce digestion or absorption of fats will decrease the ability of vitamin D to be absorbed into the body.
Not getting enough calcium and phosphorous in your diet can also lead to rickets. Rickets caused by a dietary lack of these minerals is rare in developed countries because calcium and phosphorous are found in milk and green vegetables.
Genetics may increase the risk of rickets. Hereditary rickets is form of the disease that is passed down through families. It occurs when the kidneys are unable to retain the mineral phosphate. Rickets may also be caused by kidney disorders that involve renal tubular acidosis.
Rickets is rare in the United States. It is most likely to occur during periods of rapid growth, when the body demands high levels of calcium and phosphate. Rickets may be seen in young children 6 to 24 months old and is uncommon in newborns.
==Symptoms==
Bone pain or tenderness
Arms
Legs
Spine
Pelvis
Skeletal deformities
Bowlegs
Forward projection of the breastbone (pigeon chest)
Bumps in the rib cage (rachitic rosary)
Asymmetrical or odd-shaped skull
Spine deformities (spine curves abnormally, including scoliosis or kyphosis)
Pelvic deformities
Increased tendency toward bone fractures
Dental deformities
Delayed formation of teeth
Defects in the structure of teeth, holes in the enamel
Increased incidence of cavities in the teeth (dental caries)
Progressive weakness
Decreased muscle tone (loss of muscle strength)
Muscle cramps
Impaired growth
Short stature (adults less than 5 feet tall)
==Signs and tests==
A physical exam reveals tenderness or pain in the bones, rather than in the joints or muscles.
The following tests may help diagnose rickets:
:*Blood tests (serum calcium) may show low levels of calcium.
:*Tetany (prolonged muscle spasm) may occur if serum levels of calcium are low.
:*Chvostek's sign may be positive (a spasm of facial muscles occurs when the facial nerve is tapped) indicating low serum levels of calcium.
:*Serum phosphorus may be low.
:*Serum alkaline phosphatase may be high.
:*Arterial blood gases may reveal metabolic acidosis.
:*Bone x-rays may show loss of calcium from bones or changes in the shape or structure of the bones.
:*A bone biopsy is rarely performed but will confirm rickets.
Other tests and procedures include the following:
:*PTH
:*Urine calcium
:*Calcium (ionized)
:*ALP (alkaline phosphatase) isoenzyme
==Treatment==
The treatment goals are to relieve symptoms and correct the cause of the condition. The underlying cause must be treated to prevent recurrence.
The replacement of deficient calcium, phosphorus, or vitamin D will eliminate most symptoms of rickets. Dietary sources of vitamin D include fish, liver, and processed milk. Exposure to moderate amounts of sunlight is encouraged. Treating rickets caused by metabolic abnormalities may require a special prescription for vitamin D.
Positioning or bracing may be used to reduce or prevent deformities. Some skeletal deformities may require corrective surgery.
==Expectations (prognosis)==
The disorder may be corrected with replacement of deficient minerals and vitamin D. Laboratory values and x-rays usually improve after about 1 week, although some cases may be resistant and require large doses of minerals and vitamin D.
If rickets is not corrected while children are still growing, skeletal deformities and short stature may be permanent. If it is corrected while the child is young, skeletal deformities often diminish or disappear with time.
==Complications==
Chronic skeletal pain
Skeletal deformities
Skeletal fractures, may occur without cause
Calling your health care provider
==Prevention==
Rickets may be avoided by maintaining an adequate intake of calcium, phosphorus, and vitamin D.
Renal (kidney) causes of vitamin D malabsorption should be treated promptly. Levels of calcium and phosphorus should be monitored regularly in people who have renal disorders.
Genetic counseling may help people with a family history of inherited disorders that can cause rickets.