Rickets: Difference between revisions
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==Background== | ==Background== | ||
* | *Rickets is a bone disorder characterized by soft, weak, and deformed bones | ||
*Origin of the word 'rickets' is from the word 'wrickken', to twist | |||
*The predominant cause is a [[Vitamin D deficiency]], but also inadequate calcium and impaired metabolism of vitamin D may also lead to rickets | |||
*Rickets is one of the most frequent childhood disease in many developing countries | |||
**Severe malnutrition from famine or starvation in early childhood | |||
*Vitamin D is important because it helps in the absorption of calcium and phosphate, minerals responsible for the strength and hardness of bones | |||
*This disease occurs in children (term used for adults is [[Osteomalacia]] | |||
*Risk factors for [[Vitamin D deficiency]] in infants include: | *Risk factors for [[Vitamin D deficiency]] in infants include: | ||
**Exclusive breastfed infants without vitamin D supplementation | **Exclusive breastfed infants without vitamin D supplementation | ||
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**Maternal [[Vitamin D deficiency]] | **Maternal [[Vitamin D deficiency]] | ||
***In utero, 25-hydroxyvitamin D passes through the placenta to the infant | ***In utero, 25-hydroxyvitamin D passes through the placenta to the infant | ||
==Types of [[Rickets]]== | |||
*Hereditary rickets is an inherited form of the disease | |||
**Kidneys are unable to retain phosphate | |||
*Nutritional rickets | |||
*Vitamin D Resistant Rickets | |||
*Vitamin D Dependant Rickets | |||
*Congenital Rickets | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 10:58, 13 January 2017
Background
- Rickets is a bone disorder characterized by soft, weak, and deformed bones
- Origin of the word 'rickets' is from the word 'wrickken', to twist
- The predominant cause is a Vitamin D deficiency, but also inadequate calcium and impaired metabolism of vitamin D may also lead to rickets
- Rickets is one of the most frequent childhood disease in many developing countries
- Severe malnutrition from famine or starvation in early childhood
- Vitamin D is important because it helps in the absorption of calcium and phosphate, minerals responsible for the strength and hardness of bones
- This disease occurs in children (term used for adults is Osteomalacia
- 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
Types of Rickets
- Hereditary rickets is an inherited form of the disease
- Kidneys are unable to retain phosphate
- Nutritional rickets
- Vitamin D Resistant Rickets
- Vitamin D Dependant Rickets
- Congenital Rickets
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