Rickets: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Peak incidence between 3 and 18 months of age | *Peak incidence between 3 and 18 months of age | ||
*Enlarged skull | *Enlarged and soft skull (Craniotabes) | ||
*Enlarged joints of long bones | |||
*Enlarged joints of the rib cage (aka "rickety rosary" | |||
*Double malleoli sign due to metaphyseal hyperplasia | |||
*Widening of wrist due to metaphyseal cartilage hyperplasia | |||
*Curvature of the spine and femurs | *Curvature of the spine and femurs | ||
**Bowed legs in toddlers (Genu varum) | |||
**Knock-knees in older children (Genu valgum) | |||
*Generalized muscle weakness | *Generalized muscle weakness | ||
*Bony pain or tenderness | |||
*Dental problems | |||
*Growth disturbance | |||
*Hypocalcemia | |||
**Tetany | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 10:43, 13 January 2017
Background
- Preventable condition in infants and children that is attributed to Vitamin D deficiency and Hypocalcemia
- Extreme deficiency leading to decrease bone mineralization in children, with or without hypocalcemia
- Risk factors for Vitamin D deficiency in infants include:
- Exclusive breastfed infants without vitamin D supplementation
- Dark skin pigmentation
- Maternal Vitamin D deficiency
- In utero, 25-hydroxyvitamin D passes through the placenta to the infant
Clinical Features
- Peak incidence between 3 and 18 months of age
- Enlarged and soft skull (Craniotabes)
- Enlarged joints of long bones
- Enlarged joints of the rib cage (aka "rickety rosary"
- Double malleoli sign due to metaphyseal hyperplasia
- Widening of wrist due to metaphyseal cartilage hyperplasia
- Curvature of the spine and femurs
- Bowed legs in toddlers (Genu varum)
- Knock-knees in older children (Genu valgum)
- Generalized muscle weakness
- Bony pain or tenderness
- Dental problems
- Growth disturbance
- Hypocalcemia
- Tetany
Differential Diagnosis
Evaluation
Management
- Prevention key:
- For healthy infants, children, and adolescents recommend a vitamin D intake of at least 400 IU/day