Rickets

Definition

Rickets is disease resulting from a vitamin D , calcium, or phosphate shortage in children. It causes bones to soften and weaken.

Rickets
Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Causes

Rickets results when there is a vitamin D, calcium, or phosphorous shortage in a child's body. This may occur when:

  • The supply of vitamin D from diet or sun exposure is too low
  • The way the body processes vitamin D is not typical
  • Tissue does not respond to the action of vitamin D
  • There is not enough calcium or phosphorous in the diet or it cannot be absorbed

Less often, rickets can be caused by other disorders that affect vitamin D absorption or calcium metabolism such as:

  • Kidney problems:
    • A hereditary disorder of the kidney called vitamin D-resistant rickets
    • Renal tubular acidosis—a non-hereditary kidney disorder that causes bone calcium to dissolve
    • Chronic kidney failure
    • Long-term kidney dialysis
  • Diseases of the small intestines with malabsorption
  • Disorders of the liver or pancreas disease
  • Cancer
  • Certain medications
  • Toxicity or poisoning from:
    • Cadmium
    • Lead
    • Aluminum
    • Outdated tetracycline

Risk Factors

Rickets is more common in children age 6 to 24 months. It is also more common in children of African American descent.

Factors that may increase your child's chances of getting rickets include:

  • Lack of sun exposure
  • Babies who are breastfed—breast milk is low in vitamin D
  • Babies who do not drink enough formula that is fortified with vitamin D
  • Children who do not drink enough vitamin D-fortified milk
  • Lactose intolerance with low intake of vitamin D-fortified milk
  • Family history of rickets
  • Certain chronic illnesses that result in loss of or poor absorption of calcium

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—a chest that protrudes
  • Dental deformities
  • Delayed tooth formation
  • Defects in teeth
  • Loss of appetite or weight loss
  • Difficulty sleeping
  • Muscle weakness
  • Delayed walking

Diagnosis

You will be asked about your child's symptoms and medical history. A physical exam will be done.

Your child's bodily fluids and bone may be tested. This can be done with:

  • Blood tests
  • Urine tests
  • Bone biopsy

Pictures may be taken of structures inside your child's body. This can be done with an x-ray .

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 child's diet:
    • Vitamin D-fortified dairy products
    • Foods high in vitamin D, such as fatty fish, egg yolk, and green vegetables
    • Foods high in calcium
    • Supplements of vitamin D, calcium, and other minerals
    • Biologically active vitamin D
  • Adequate, but not excessive, exposure to sunlight
  • Avoiding medication that may be causing poor calcium absorption
  • Treating underlying illnesses

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

Prevention

To help prevent rickets, your child should:

  • Drink vitamin D-fortified milk.
  • Consume enough vitamin D , calcium, and other minerals. If you think your child's diet may be lacking, talk with the doctor about other sources of vitamins and minerals.
  • Get sufficient, but not excessive, exposure to sunlight. Fifteen minutes a day is usually enough. Any longer than that requires sun protection with clothing or sunscreens, especially in fair-skinned infants and children. Children with dark skin are at increased risk for rickets and may need more sun exposure and dietary supplements with vitamin D.
  • Breastfed babies and bottle-fed babies who do not get enough vitamin-D fortified formula may need to be given a supplement starting within the first few days of life. Talk to the doctor to make sure your child is meeting the nutritional requirements for vitamin D.

Revisions

Please note, not all procedures included in this resource library are available at Allegiance Health or performed by Allegiance Health physicians.

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at HLEditorialTeam@ebscohost.com.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Editorial Policy | Privacy Policy | Terms and Conditions | Support
Copyright © 2008 EBSCO Publishing. All rights reserved.

Staying active will help you develop a strong body, lower your risk for disease, reduce stress and protect your bones and joints. Keep things interesting by mixing it up; don't be afraid to try something new.