Early clinical manifestations of rickets

Written by Li Jiao Yan
Neonatology
Updated on September 05, 2024
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Early Symptoms of Rickets:

Rickets is a chronic nutritional disease caused by a deficiency in Vitamin D, leading to disordered calcium and phosphorus metabolism and resulting in abnormal skeletal development. It primarily affects infants, especially those under six months old, with the highest occurrence in infants under three months. The general symptoms include heightened neural excitability, such as fussiness, easy irritability, sudden bouts of crying, or being so sensitive that they cry when touched. Other symptoms include excessive sweating and frequent head shaking, though these are not specific indicators of rickets.

Diagnosis mainly relies on biochemical markers and Vitamin D levels, like decreased blood calcium and phosphorus levels, elevated parathyroid hormone levels, and reduced 25-hydroxy-D3. X-ray images of bones might appear normal.

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Written by Zeng Hai Jiang
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The difference between rickets and rib flare

Rickets and rib flaring are different; rib flaring can be considered a symptom of rickets. Rickets is caused by a deficiency of vitamin D in infants and children, leading to abnormal metabolism of calcium and phosphorus, which results in incomplete calcification and softening of the bones, thereby causing skeletal deformities. Rickets can be divided into initial, active, recovery, and sequelae stages. During the active stage of rickets, skeletal deformities such as softened skull, "ping pong" head, square skull, rib flaring, pigeon chest, funnel chest, X-shaped legs, and O-shaped legs are prone to occur.

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Written by Wang Xiao Jing
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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 Tong Peng
Pediatrics
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Does rickets have anything to do with milk powder?

Rickets is not necessarily linked to formula milk. Rickets is mainly a metabolic bone disease caused by a deficiency of vitamin D in the body, while the main components of formula milk are various nutrients, including trace elements and vitamins. If the formula contains insufficient calcium, it may exacerbate the symptoms of rickets. Therefore, the main requirement is to intake enough vitamin D. National child healthcare guidelines require that children be supplemented with 400 to 800 units of vitamin D daily from two weeks after birth until the age of two. Additionally, it is important to get ample sunlight in daily life and engage in reasonable outdoor activities to promote calcium absorption, which can effectively prevent rickets. The amount of vitamin D and calcium in formula milk cannot meet the growth and developmental needs of children, so additional supplementation is necessary. Thus, there is a certain connection between rickets and formula milk, but it is not inevitable.

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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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Can rickets with rib eversion in babies be cured?

Babies with rib flaring can be treated, but it requires assessment based on relevant clinical symptoms and laboratory tests. First, it is necessary to understand that rickets is a metabolic bone disease caused by a deficiency of vitamin D, which often results not only in rib flaring but also in square skull, pigeon chest, and either bowlegs or knock-knees. Neurologically, symptoms may include night sweats, easy startling during sleep, and poor sleep quality. When these conditions occur, a physical examination by a specialist is essential, along with comprehensive tests, including measuring the specific levels of vitamin D, and selecting appropriate vitamin D supplements. If the symptoms of rib flaring are severe and accompanied by a noticeable pigeon chest, orthotic supports may also be necessary for correction. If rib flaring affects normal breathing, severe cases may require surgical treatment. Therefore, the extent of severity based on clinical symptoms will dictate the treatment approach—whether it is oral medication, orthotic correction, or surgery.