Rickets
Condition
Definition
Rickets is a rare bone disease. It causes bones to soften and weaken.
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Causes
Rickets is caused by a lack of vitamin D, calcium, or phosphate in the body. This may happen due to:
- Lack of sun exposure so the body cannot create vitamin D
- Not eating enough foods with vitamin D, calcium, or phosphorous
- Problems in the body that prevent it from absorbing vitamin D, calcium, or phosphate
- Genetic problems, such as vitamin D-resistant rickets
Risk Factors
Rickets is more common in children who:
- Are 6 to 24 months of age
- Have darker skin
Other things that may raise the risk are:
- Breastfeeding without vitamin D supplementation
- Lack of sun exposure
- Vegetarian diet without vitamin supplements
- Malabsorption syndromes, such as Celiac disease or cystic fibrosis
- Being born very early
- Having a mother with vitamin D deficiency during pregnancy
- Drugs that affect vitamin D, calcium, or phosphorous absorption or use
Symptoms
Problems may be:
- Muscle weakness
- Bowed legs
- Bone pain in the back, pelvis, and legs
- Seizures
- Muscle spasms
- Skeletal and/or skull deformities
Diagnosis
You will be asked about your child's symptoms and health history. A physical exam will be done. This may be enough to suspect rickets.
The diagnosis may be confirmed with:
- X-rays
- Blood tests
Treatment
The underlying cause will need to be treated. The goals of treatment are to relieve or reverse symptoms.
Vitamin D, calcium, or phosphate supplements will be given. Children with severe symptoms may need surgery to correct bony deformities.
Prevention
To lower the risk of rickets:
- Encourage children to eat foods that are high in calcium and vitamin D.
- Allow some exposure to sunlight. Fifteen minutes a day is usually enough. Any longer than that requires sun protection.
- Breastfed babies and bottle-fed babies who do not get enough vitamin D fortified formula may need to be given a supplement.
Eat Right—Academy of Nutrition and Dietetics
Healthy Children—American Academy of Pediatrics
CANADIAN RESOURCES:
Health Canada
The Hospital for Sick Children—About Kids Health
Eat Right—Academy of Nutrition and Dietetics
Healthy Children—American Academy of Pediatrics
CANADIAN RESOURCES:
Health Canada
The Hospital for Sick Children—About Kids Health
References
- Mughal MZ. Rickets. Curr Osteoporos Rep. 2011 Dec;9(4):291-299.
- Rickets. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/rickets. Accessed December 1, 2020.
- Rickets. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/rickets.html. Accessed December 1, 2020.
- Vitamin D deficiency in children (infancy through adolescence). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/vitamin-d-deficiency-in-children-infancy-through-adolescence. Accessed December 1, 2020.
Contributors
- Marcin Chwistek, MD
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