What is rickets?
Rickets is a disease in children that causes the bones to develop softer than normal, resulting in muscle and bone weakness and deformity. Rickets is impaired mineralization of the growth plates of bones. The most common cause of rickets is a lack of vitamin D.
Rickets is uncommon in the United States, but its incidence is increasing. Children at risk for developing soft bones typically possess one or more risk factors associated with low vitamin D and calcium levels. Darker skinned children require more sunlight to make vitamin D and are more at risk if sunlight exposure is limited, such as during the winter months. Children who are lactose intolerant, strictly breastfed, or have a genetic disorder affecting the absorption of vitamin D, are also at risk for rickets.
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Rickets is caused by faulty mineralization in the bone-building process. Because vitamin D, calcium, and phosphorus are needed to build strong bones, a lack of these substances will affect the bones. Multiple factors can affect vitamin D levels, including the environment, genetics and diet. The environment can play a role in vitamin D deficiency because sunlight is responsible for the production of vitamin D in the body. Genetic disorders affecting vitamin D absorption can also cause rickets. Not consuming enough milk and dairy products, which are high in vitamin D and calcium, is also associated with developing rickets. Other less common causes of rickets are liver and kidney diseases and cancer.
The signs and symptoms of rickets can be constant or occur periodically. Rickets varies among individuals. Some children with rickets have mild symptoms, such as muscular discomfort, while others may have severe bowing of bones and frequent bone fractures. Fortunately, rickets can be treated with nutritional supplementation to resolve vitamin D, calcium, and phosphorus deficiencies. Lifestyle changes can reduce the risk for rickets and include receiving adequate sun exposure, eating a well-balanced diet that includes milk and dairy products, and taking all medication or supplements as prescribed.
In some cases, rickets can lead to serious bone fractures and should be treated. Seek immediate medical care (call 911) if your child’s rickets includes serious signs and symptoms, such as deformity or dislocation of the joint, extensive swelling, numbness, bone protruding through the skin, or severe pain.
Seek prompt medical care if your child is being treated for rickets but mild symptoms, such as numbness, swelling, or trouble moving, recur or are persistent.
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- Rickets. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001384/
- Rickets. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00577
- Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013
- Misra M, Pacaud D, Petryk A, et al. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 2008; 122:398