What is Rickets?
Rickets is a skeletal condition characterised by a Vitamin D, Calcium, or phosphate deficiency. These nutrients are required for the development of strong, healthy bones. Rickets can cause weak and soft bones, delayed development, and, in extreme cases, skeletal abnormalities. Vitamin D deficiency makes it difficult for the body to maintain adequate calcium and phosphate levels. When this happens, the body creates hormones that cause calcium and phosphate from the bones to be released.
When the bones lack certain minerals, they become weak and brittle. Rickets is most common in children between 6 to 36 months. Children are most vulnerable to rickets since they are still growing. Kids who live in areas with less sunshine or who do not consume milk products may not get enough vitamin D. The condition is hereditary in some cases.
Symptoms
Some signs and symptoms of rickets may include the following:
- Bones that grow slowly
- Bone pain or tenderness
- Muscle weakness
- Bowed or curved legs
- A large forehead or abdomen
- Bones that are soft and break easily
- Wide joints in the elbows and wrists
- Dental problems
- An unusual rib and breastbone shape
When To See a Doctor?
In case of significantly lower calcium levels in the blood can cause cramping, seizure, and breathing difficulties. Long-term nutritional rickets can increase the risk of easily breaking bones, chronic bone abnormalities, heart problems, pneumonia, obstructed labour, and potentially lifelong disability if not treated promptly. As a result, it is important to visit a doctor as soon as the symptoms in a child are detected. If rickets is not treated during a child's developing stage, the kid may grow to be very short as an adult. If the disorder is not addressed, the defects may become permanent.
Causes
Rickets is mainly caused by nutrient deficiencies or genetics, and a deficiency of vitamin D or calcium is the most frequent cause of rickets. The fundamental source of vitamin D is sunlight exposure, but it's also available in some foods, such as oily fish, red meat, liver and eggs.
Inherited rickets: Several genetic diseases in kids hamper vitamin D absorption. Rickets is also caused by other hereditary disorders that impair how the body processes phosphorus. Although, these causes of rickets are uncommon.
Risk Factors
Certain factors may increase the child's vulnerability and risk of developing rickets. They are as follows:
- Due to high levels of melanin pigment, which limits the skin's capacity to synthesise Vitamin D from the sun, people with dark skin are more likely to get rickets.
- In India's colder regions, there is a limited exposure to sunshine.
- Low absorption of vitamin D, calcium, and phosphorus-rich foods.
- Infants who are only fed breast milk, which contains little Vitamin D.
- Individuals who spend more time indoors during the day.
Complications
Rickets caused by a calcium deficiency can involve seizures, respiratory issues, and cramping in children. However, in the long run, it might lead to serious complications, such as
- Short stature
- Multiple bone fractures
- Pneumonia
- Hypoplasia of the teeth
- Cardiomyopathy
- Hydrocephalus
- Seizures
- Cavities in teeth
- Irregularities in the bones
Prevention
In most cases, parents can prevent rickets in their children. It is important that children get adequate calcium and vitamin D. Unless the doctor advises it, do not give vitamin supplements to children.
Children should be fed vitamin D-rich meals like breakfast cereals, orange juice, and calcium-rich foods like milk, cheese, and salad greens. Check with your doctor about how much sun exposure is required for youngsters. Remember that newborns and babies need to be protected from direct sunlight.
Diagnosis
A physical examination may be able to determine rickets. The doctor will inspect the bones to look for soreness, pain or discomfort. They will pay particular attention to your child's:
- Skull: Babies with rickets usually have softer skull bones and may experience a delay in the closure of soft areas (fontanels).
- Legs: While even healthy babies are a bit bowlegged, rickets is characterised by severe leg bending.
- Chest: Some rickets patients have anomalies in their rib cages, causing their chest bones to protrude.
- Wrists and ankles: Children with rickets frequently have larger or thicker wrists and ankles than usu
- Blood tests: Blood tests are done to determine the levels of calcium, phosphorus, parathyroid hormone, and alkaline phosphatase (ALP) in the blood.
- Urine test: This test helps to find out the amount of calcium in the urine. An unusually high urinary calcium alongwith low blood calcium levels is important in diagnosing rickets.
- Bone X-rays: Bone X-rays:X-rays of the bones are done to look for bone deformities.
- Bone Biopsy: In rare cases, a bone biopsy may be conducted involving removing a small portion of the bone and sending it to a laboratory for investigation.
- DEXA Scan: A bone densitometry test that uses spectral imaging to determine the bone mineral density (BMD).
The doctor may recommend certain medical tests that can help detect the condition, the tests are:
Treatment
Treatment for rickets focuses on replacing the missing vitamins or minerals in the body and eliminating most of the ricket symptoms. If the child is vitamin D deficient, your doctor will likely advise to get more sunlight as well as encourage to consume foods high in vitamin D, such as fish, liver, milk, red meat and eggs.
Rickets can also be treated with calcium and vitamin D supplements. Ask your doctor about the proper dosage, which might vary depending on the child's age. Too much calcium or vitamin D might be harmful.
If the child has skeletal deformities, braces may be required to place their bones correctly as they grow. The youngsters may require corrective surgery in severe cases.
To treat genetic rickets, a combination of phosphate supplements and high levels of a specific kind of vitamin D is required.
Lifestyle changes and selfcare
Direct sunlight exposure to the skin (hands, face, arms, etc.) stimulates the body's production of vitamin D. However, clothing and sunscreen prevent the UV radiation that causes vitamin D formation from reaching the skin. Depending on the location, sunlight may not provide enough UV radiation to promote adequate vitamin D production during the winter. At other times of the year, even 30 minutes of sun exposure each day will generally result in significant increase in the formation of vitamin D. If getting enough sunlight is difficult, full-spectrum light can be used to boost vitamin D production.
Do’s and Don’ts
Increasing vitamin D, calcium, and phosphate levels will help treat rickets. Many children with rickets show improvement within one week. If this condition is treated during young age, bone deformities often heal or disappear over time. On the other hand, skeletal anomalies may become permanent if not corrected throughout a child's development.
| Do’s | Don’ts |
| Increase intake of dairy products. | Avoid any new and sudden symptoms. |
| Make sure women have good vitamin D levels during pregnancy. | Avoid medications prescribed by the doctor. |
| Encourage kids to exercise and eat calcium-rich foods. | Avoid taking the diet prescribed by the doctor. |
| Make sure kids get enough vitamin D. | Start self-medicating without consulting the doctor. |
Care at Medicover Hospitals
At Medicover, we have the best team of paediatricians and orthopaedic doctors who work together to provide rickets treatment with utmost precision. Our highly skilled healthcare team utilises the latest medical approach, diagnostic procedures and advanced healthcare technologies to treat various paediatrician conditions and ailments. For treating rickets, we adopt a multi-disciplinary approach, provide comprehensive care to the patients, and attend to all their medical needs for faster and sustained recovery.
