Early symptoms of rickets

Written by Li Jiao Yan
Neonatology
Updated on September 15, 2024
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Rickets is a chronic systemic nutritional disease caused by insufficient vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism, characterized by skeletal lesions, typically presenting as incomplete mineralization of the long bones' growth plates and bone tissue. In the early stages of rickets, skeletal development abnormalities are not very obvious. Infants under three months often exhibit signs of increased neural excitability, such as being prone to crying, sweating easily, and potentially frequent head shaking; however, these symptoms are not necessarily specific to rickets. Generally, at this time, there are no obvious abnormalities in skeletal development, and X-rays of the bones are normal. The focus is on vitamin levels, specifically decreased serum 25-hydroxy vitamin D, as well as reduced blood calcium and phosphorus levels. Therefore, early symptoms are not so typical. It is recommended that children regularly visit pediatric clinics for physical examinations to assess their development and, if necessary, undergo trace element and vitamin D level checks.

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Written by Yao Li Qin
Pediatrics
1min 16sec home-news-image

The main manifestations of rickets in the early stage

Rickets generally refers to vitamin D deficiency rickets, mainly due to insufficient vitamin D in children, leading to calcium and phosphorus metabolism disorders. It is a chronic nutritional disease characterized by skeletal lesions. The main manifestations are changes in the fastest growing parts of the skeleton, which can also affect muscle development and changes in neural excitability. The initial symptoms of rickets are common in infants, especially those under three months old. The main symptom is increased neural excitability; the child is particularly prone to being agitated, irritable, crying, sweating, and shaking their head due to scalp stimulation, but these are not specific symptoms of rickets. Therefore, blood tests are still necessary in the early stages, showing decreased levels of 25-hydroxyvitamin D3, blood calcium, and blood phosphate, increased PTH, normal or slightly elevated alkaline phosphatase activity, and normal or slightly blurry calcification zones in skeletal X-rays. These are the early manifestations of rickets.

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Written by Li Jiao Yan
Neonatology
1min 25sec home-news-image

Early symptoms of rickets

Rickets is a chronic systemic nutritional disease caused by insufficient vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism, characterized by skeletal lesions, typically presenting as incomplete mineralization of the long bones' growth plates and bone tissue. In the early stages of rickets, skeletal development abnormalities are not very obvious. Infants under three months often exhibit signs of increased neural excitability, such as being prone to crying, sweating easily, and potentially frequent head shaking; however, these symptoms are not necessarily specific to rickets. Generally, at this time, there are no obvious abnormalities in skeletal development, and X-rays of the bones are normal. The focus is on vitamin levels, specifically decreased serum 25-hydroxy vitamin D, as well as reduced blood calcium and phosphorus levels. Therefore, early symptoms are not so typical. It is recommended that children regularly visit pediatric clinics for physical examinations to assess their development and, if necessary, undergo trace element and vitamin D level checks.

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Written by Mo Ming Hua
Pediatrics
1min 15sec home-news-image

If rickets is not treated, what will be the impact?

Rickets, if untreated, mainly involves changes in skeletal deformities and motor function in children. Rickets is primarily caused by a deficiency in vitamin D, which is essential for promoting the absorption of calcium. A deficiency in vitamin D leads to reduced calcium absorption. Lower calcium absorption results in a calcium deficiency in the body, which in turn causes changes in the bones. In the early stages of vitamin D deficiency, the main symptoms are increased neural excitability, which may manifest as startle reactions, irritability, restlessness, and excessive sweating. During the active phase, symptoms of increased nervous system excitability become more pronounced, mainly presenting as skeletal deformities. What aspects do these skeletal deformities affect? One is the softening of the skull, pigeon chest, funnel chest, and changes resembling wristbands and anklets. If the condition worsens further, it can present as X-shaped legs, O-shaped legs, and spinal deformities. Thus, if rickets progresses, it can lead to skeletal deformities and impairments in motor functions, among other issues.

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Written by Li Jiao Yan
Neonatology
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Can rickets be cured?

Rickets refers to a nutritional disease characterized by bone lesions caused by disorders in calcium and phosphorus metabolism due to a deficiency of vitamin D in the body. The primary treatment for rickets involves early detection and comprehensive treatment at an early stage, which is crucial. The general treatment goal is to control the active phase, prevent deformities, and avoid recurrence. Nutritional rickets due to a deficiency of vitamin D is a self-limiting disease; it can be cured once infants and young children engage in sufficient outdoor activities and supplement with vitamin D. Early detection of low vitamin D levels or abnormalities in calcium and phosphorus metabolism, along with early proactive intervention, can prevent the occurrence of skeletal deformities. If sequelae are present, there is no need for medication; mild to moderate cases should strengthen physical exercise, and skeletal deformities can be corrected through active or passive rehabilitation movements. Severe skeletal deformities can be corrected through surgical treatment.

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Written by Tong Peng
Pediatrics
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Will rickets lead to hunchback when grown up?

Rickets generally does not result in hunchback when one grows up, as rickets is a disease caused by a vitamin D deficiency leading to disturbances in calcium and phosphorus metabolism. If not cured before development is completed, it often leaves sequelae such as square skull, Harrison's groove, beaded ribs, as well as bow legs, knock knees, and pigeon chest. However, hunchback is mainly caused by developmental deformities of the thoracic and lumbar spine, and is not greatly related to a lack of vitamin D. However, it is also important to note that a deficiency in vitamin D can lead to osteoporosis, and if one does not maintain proper posture in daily life, such as bending the back while sitting, standing, or walking and not being able to stand straight, it may eventually lead to pathological curvature of the spine and thoracic vertebrae. Therefore, in daily life, it is still important to be conscious of using one’s lumbar and thoracic spine correctly to avoid developing a hunchback over time.