How is rickets diagnosed?

Written by Li Jiao Yan
Neonatology
Updated on September 14, 2024
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Rickets is a chronic nutritional disease characterized by skeletal changes, resulting from insufficient Vitamin D in children, which leads to disruptions in calcium and phosphorus metabolism. Diagnosis of rickets requires a measure of Vitamin D levels, clinical manifestations, certain biochemical markers in blood, and skeletal X-ray findings. Typically, Vitamin D levels are significantly lower than usual, with the level of 25-hydroxyvitamin D3 being the most reliable diagnostic standard. However, many facilities are unable to perform this test, so some instead rely on blood biochemistry and skeletal X-rays. Currently, blood biochemistry and skeletal X-ray examinations are considered the gold standard for diagnosis.

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Written by Li Jiao Yan
Neonatology
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Nursing Measures for Children with Rickets

Rickets requires relevant home care. During the active phase of rickets, it is best to avoid early sitting, standing, and walking. For chest deformities, prone neck lifting and chest expansion exercises can be performed. For lower limb deformities, muscle massage can be done. For bow legs, massage the outer leg muscles and perform abductive and external rotation exercises after massaging both knee joints. For knock knees, massage the inner muscle group and perform internal rotation exercises after massaging both ankle joints. For posterior protrusion of the lumbar spine, massage the lumbosacral area and frequently lie prone to increase muscle tone, assisting in the recovery of deformities. For mild to moderate bow legs, it may be appropriate to slightly elevate the outside of the shoe by about 0.5 cm. For mild to moderate knock knees, it may be appropriate to slightly elevate the inside of the shoe by about 0.5 cm. Observe for one to three months and adjust the padding height as necessary, which generally can correct the condition. Additionally, children should be exposed to more outdoor sunlight and have a rich nutritional intake, including nutrient-rich proteins and dairy products to aid in recovery from the disease.

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Written by Wang Xiao Jing
Pediatrics
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How to prevent skeletal deformities in rickets

Rickets is mainly caused by a deficiency of vitamin D. Therefore, within half a month after a child's birth, a preventive dose of oral vitamin D should be administered. Continue breastfeeding, allow the baby to get plenty of sunlight when the weather is warm, and timely introduce calcium-rich supplementary foods. In the early and active stages of rickets, appropriate supplementation with calcium and vitamin D can prevent the occurrence of skeletal deformities caused by the disease.

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Written by Yao Li Qin
Pediatrics
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Clinical manifestations of rickets

Rickets, also known as vitamin D deficiency rickets, occurs because children do not supplement vitamin D in a timely manner after birth, leading to a deficiency of vitamin D in the body and resulting in a nutritional metabolic disease primarily involving skeletal changes. In the early stages, children mainly show symptoms related to mental and emotional state, such as irritability, crying, excessive sweating, shaking their heads back and forth, and rubbing their heads. Subsequently, symptoms like bald patches on the back of the head and softening of the skull bones may appear. As children grow, they may develop conditions such as a square-shaped skull, beaded ribs, pigeon chest, funnel chest, and bracelet-like deformities around the wrists and ankles. In severe cases, children may later develop X-shaped legs and O-shaped legs. If rickets is suspected, it is crucial to promptly conduct a blood test to measure the vitamin D level. If the level is below normal, it is essential to actively treat the diagnosed rickets.

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Written by Li Jiao Yan
Neonatology
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Can rickets be treated?

Rickets is a disorder caused by a deficiency of vitamin D, leading to impaired calcium and phosphorus absorption, which then results in abnormal skeletal development. It is a chronic nutritional disease. Generally, the rickets commonly mentioned is due to nutritional vitamin D deficiency, which is treatable. Typically, encouraging children to engage in appropriate physical activities while supplementing with an adequate level of vitamin D can effectively control the disease, and it can even be cured. However, if there are special circumstances, such as significant liver abnormalities, renal function abnormalities, renal failure, or abnormalities in the thyroid or parathyroid glands, including parathyroid tumors, or congenital hereditary diseases, the treatment needs to be based on the cause in order to effectively control the disease and promote normal calcium and phosphorus metabolism in the body. Congenital hereditary diseases generally make treatment more challenging. Therefore, it is crucial for children with rickets to seek timely medical examination at a hospital. If it is a common case of nutritional vitamin D deficiency, parents should supplement vitamin D promptly according to the doctor's advice for treatment.

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Written by Li Jiao Yan
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Can rickets be cured?

Rickets is a chronic nutritional disease caused by vitamin D deficiency that leads to disturbed calcium and phosphorus metabolism in the body, causing abnormal skeletal development. If a square skull is observed, it indicates that the child's disease has entered an active phase. Generally, in the early stages, there is an enlargement of the fontanelle or a delay in the closure of the fontanelle. By seven to eight months, a square skull can appear, primarily characterized by outward bulging centered on the frontal and parietal bones. At this time, it is generally necessary to administer a sufficient dose of vitamin D and encourage appropriate outdoor activities. Depending on the child's condition, it might be appropriate to supplement with calcium as well. Gradually, this should be curable; however, if there are other special causes for the abnormal vitamin D levels, such as severe liver or kidney disease or some new genetic diseases causing square skull, the treatment might be more challenging.