Diseases & Conditions

Rickets

Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency.

Vitamin D is essential in promoting absorption of calcium and phosphorus from the gastrointestinal tract, which your child needs to build strong bones. A deficiency of vitamin D makes it difficult to maintain proper calcium and phosphorus levels in bones.

If a vitamin D or calcium deficiency causes rickets, adding vitamin D or calcium to the diet generally corrects any resulting bone problems for your child. Rickets due to a genetic condition may require additional medications or other treatment. Some skeletal deformities caused by rickets may need corrective surgery.

Vitamin D deficiency begins slowly before physical signs and symptoms of rickets appear. When rickets signs and symptoms develop, they may include:

• Skeletal deformities. These include bowed legs, abnormal curvature of the spine, pelvic deformities and breastbone projection in the chest.
• Fragile bones. Children with rickets are more prone to bone fractures.
• Impaired growth. Delayed growth in height or limbs may be a result of rickets.
• Dental problems. These include defects in tooth structure, increased chance of cavities, poor enamel and delayed formation of teeth.
• Bone pain. This includes dull, aching pain or tenderness in the spine, pelvis and legs.
• Muscle weakness. Decreased muscle tone may make movement uncomfortable.

When to see a doctor
If your child exhibits signs or symptoms of rickets, such as bone pain, muscle weakness or obvious skeletal problems, make an appointment with your child's doctor.

The aim of treatment for rickets is to solve the underlying disorder. If deficiencies in vitamin D, calcium or phosphorus are at fault, replacing vitamin D and those minerals generally eliminates the signs and symptoms of rickets, such as bone tenderness and muscle weakness. Improvement generally occurs within three months.

Your doctor may prescribe a vitamin D supplement or ask you to increase your intake of vitamin D-fortified foods, including fortified breakfast cereal, orange juice, fish and processed milk.

Getting a sufficient intake of calcium is crucial to maintaining healthy bones. Your doctor can suggest an appropriate level of calcium intake depending on your age and whether you have absorption problems. The combination of increased vitamin D intake with calcium may be enough to eliminate the effects of rickets entirely.

Treating complications
For some cases of bowlegs or spinal deformities, your doctor may suggest special bracing to position your child's body appropriately as the bones grow. More severe skeletal deformities may require surgery.