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Rickets Info: Definition Causes Risk Factors Symptoms Diagnosis Treatment Prevention

Definition
This is a metabolic bone disease resulting from vitamin D deficiency. It is called rickets in children and osteomalacia in adults. Both cause softening and weakening of bones because of defective or inadequate bone mineralization.

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Causes
Rickets and osteomalacia result when there is a vitamin D deficiency in the body. This may occur when:

	The supply of vitamin D is inadequate.
	The metabolism of vitamin D is abnormal.
	Tissues are resistant to the action of vitamin D. Vitamin D regulates calcium absorption in the body. It also controls levels of calcium and phosphate in bone. Vitamin D is absorbed in the intestines from food. Vitamin D is also produced by the skin during exposure to sunlight. Most often, rickets and osteomalacia are caused by a deficiency of vitamin D. This can result from insufficient vitamin D in the diet. In children, this may be related to:
	- Insufficient vitamin D-fortified milk.
	- Insufficient vitamin D supplements to children being breast fed or to children who are lactose intolerant.
	- Lack of exposure to sunlight. This is usually due to extended playtime indoors rather than outdoors.
	Less often, rickets and osteomalacia can be caused by other disorders that affect vitamin D absorption, metabolism, or action in the body such as:
	Kidney problems:
	- A hereditary disorder of the kidney called vitamin D-resistant rickets
	- Renal tubular acidosis — a non-hereditary kidney disorder which causes bone calcium to dissolve
	- Chronic kidney failure
	- Long-tern kidney dialysis
	Diseases of the small intestines with malabsorption
	Disorders of the liver or pancreas disease
	Cancer
	Certain drugs, such as:
	- Certain seizure medications, such as phenytoin or phenobarbital
	- Acetazolamide
	- Ammonium chloride
	- Disodium etidronate
	- Fluoride treatment
	Toxicity or poisoning from:
	- Cadmium
	- Lead
	- Aluminum
	- Outdated tetracycline

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Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

	Age in children: 6-24 months old
	Age in adults: 50-80 years
	Lactose intolerance with inadequate intake of vitamin D-fortified milk
	Family history of rickets
	Race: Black

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Symptoms

Symptoms may include:

	Bone pain and tenderness
	Skeletal and/or skull deformities
	Bow legs or knock knees
	Deformity or curvature of the spine
	Pigeon chest (forward protrusion of the chest bone)
	Impaired growth, resulting in short stature
	Susceptibility to bone fractures
	Dental deformities
	Delayed tooth formation
	Defects in teeth
	Increased cavities
	Loss of appetite or weight loss
	Difficulty sleeping
	Poor muscle development and tone
	Muscle weakness
	Delay of learning to walk in children

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Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests to confirm the diagnosis may include:

	Blood and urine tests
	Bone X-rays
	Bone biopsy, when other tests are not conclusive

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Treatment

Treatment attempts to:

	Correct the underlying cause
	Relieve or reverse symptoms

Treating the Underlying Cause

Treatment of the underlying cause may include:

	Adding the following to your diet:
	- Vitamin D-fortified milk products
	- Foods high in vitamin D (such as fatty fish, egg yolk, and green vegetables)
	- Supplements of vitamin D, calcium, and other minerals
	- Biologically active vitamin D
	Adequate but not excessive exposure to sunlight

Treating Symptoms

Treatment to relieve or correct symptoms may include:

	Wearing braces to reduce or prevent bony deformities
	In severe cases, surgery to correct bony deformities

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Prevention

To help prevent rickets or osteomalacia:

	Drink vitamin D-fortified milk
	Get sufficient vitamin D, calcium, and other minerals. If you think your diet may be deficient, talk with your doctor about alternate sources of vitamins and minerals.
	Get sufficient, but not excessive, exposure to sunlight 15 minutes a day is usually considered sufficient. Any longer than that requires sun protection with clothing or sunscreens, especially in infants or children.

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