A softening of bones due to deficiency or impaired metabolism of vitamin D, phosphorus or calcium, potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries. The predominant cause is a vitamin D deficiency, but lack of adequate calcium in the diet may also lead to rickets (cases of severe diarrhea and vomiting may be the cause of the deficiency). Although it can occur in adults, the majority of cases occur in children suffering from severe malnutrition, usually resulting from famine or starvation during the early stages of childhood.
In rare instances, children may be born with a genetic form of rickets. It may also develop if another condition affects how minerals and vitamins are absorbed by a person's body. Rickets usually occurs because of a lack of calcium or vitamin D, although it may also be caused by a genetic defect or another health condition. Over a long period of time, deficiency of vitamin D causes rickets in children and osteomalacia in adults.
Rickets is more common in children of African-Caribbean, Asian, and Middle Eastern origin because their skin is darker and needs more sunlight to get enough vitamin D. Any child; however, who does not get enough sunlight, has a diet low in calcium or vitamin D, or is covered up often is also at risk of experiencing rickets. Babies who are born prematurely are also at risk of developing rickets because the fetus builds up stores of vitamin D while in the womb. As the amount of vitamin D in breast milk does vary, it is recommended that all pregnant and breastfeeding women take a daily supplement of 10 micrograms of vitamin D. Doing so ensures a mother's vitamin D requirements are met and that adequate fetal stores are built up for early infancy.
Rare Genetic Rickets
Rare forms of rickets may also be inherited. 'Hypophosphatemic,' rickets is a genetic disorder in which a person's bones and kidneys deal irregularly with phosphate. The result is too little phosphate in the person's blood and bones, leading to weak and soft bones.
Additional types of genetic rickets affect certain proteins in a person's body that are used by vitamin D. On occasion, rickets develops in children who experience rare forms of liver, kidney, and intestinal conditions. The conditions can affect their ability to absorb and metabolize minerals and vitamins.
Symptoms of Rickets
Rickets causes a person's bones to become soft, weak, and painful. The condition leads to deformities of a person's skeleton such as curvature of the spine, bowed legs, and thickening of the wrists, ankles, and knees. Signs and symptoms of rickets include the following:
Pain: A person's bones affected by rickets are many times sore and painful. A child might be reluctant to walk, or may tire easily.
Skeletal Deformities. Skeletal deformities include bowed legs, soft skull bones, curvature of the spine, as well as thickening of the wrists, ankles, and knees. The person's breastbone may also stick out.
Fragile Bones: A person's bones become weaker and more prone to fractures.
Poor Growth and Development: A person who experiences rickets has a skeleton that does not grow and develop properly; a child will be shorter than average.
Dental Issues: Dental issues a person with rickets may experience include a delay in teeth coming through, weak tooth enamel, and an increased risk of cavities.
As a child with rickets ages, the symptoms they experience may also include bent bones, 'waddling,' while walking, as well as muscle pain and weakness. The symptoms can also affect adults who have osteomalacia. If your child experiences any of the symptoms of rickets, delayed growth, bone pain, skeletal issues, or muscles weakness it is important to take them to a doctor for a check-up.
If a doctor suspects rickets, they might perform a number of tests to include a physical examination, blood tests, and an x-ray. A physical examination will check for any obvious issues with your child's skeleton such as tenderness and bone pain. A doctor may arrange for your child to have some blood tests to measure phosphorous, calcium, and vitamin D levels. The doctor will discuss your child's diet, medical history, medications, and family history. Your child might also have some x-rays or perhaps a bone densitometry scan, a certain type of x-ray that measures the calcium content in a person's bones.
Rickets may be successfully treated in the majority of children by making sure they eat foods that contain vitamin D and calcium or by ensuring they take vitamin and mineral supplements. If your child has issues with absorbing vitamins and minerals they might need a higher dose, or yearly vitamin D injections. Rickets can easily be prevented by eating a diet that includes calcium and vitamin D and by spending some time in the sunlight. A person's hands and face only need to be exposed to sunlight a few times a week during spring and summer.
Diet: Make sure your child has a balanced and healthy diet containing plenty of vitamin D and calcium. Sources of vitamin D include eggs, oily fish, margarine, liver, and breakfast cereals with added vitamin D. Sources of calcium include dairy products, wholemeal bread, beans, lentils, dried fruits, and green vegetables. If you have a restricted diet, or if you are a vegan or vegetarian, you might not be receiving essential vitamins and minerals and may need to take a vitamin supplement.
Sunlight: Sunlight is a good source of vitamin D and is where most of our vitamin D comes from. The vitamin forms under a person's skin due to exposure to the sun. Around 10-15 minutes of exposure to the sun on a person's hands and face, a few times a week during the spring and summer is enough. Be aware that too much sun is bad for a person's skin, so it is also important not to spend lengthy periods of time in the sun. Always use sunscreen with a sun protection factor (SPF) of at least 15. Babies and young children have skin that is sensitive and burns easily and need to use stronger sunscreen.