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 Tong Peng

Pediatrics

59sec

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Can people with rickets swim?

Rickets is a metabolic disease caused by a deficiency in vitamin D, and its clinical manifestations primarily include symptoms in infants such as a square skull, night sweats, pigeon chest, eversion of the rib cage, as well as bowlegs or knock-knees. Severe cases can lead to skeletal deformities in the chest and developmental disorders. Therefore, for the treatment of children with rickets, it is necessary to intake vitamin D and calcium to promote bone development. Swimming is also a form of exercise that can enhance the absorption of calcium by the bones, which can help prevent the progression of rickets. It is also important to engage in outdoor activities and expose to sunlight, as vitamin D can be synthesized through sun exposure, effectively supplementing it. If a child's symptoms of rickets are relatively severe, it is advisable to take the child to a specialist hospital for a 25-hydroxy vitamin D test and supplement vitamin D based on the specific results.

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Written by Li Jiao Yan

Neonatology

57sec

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Why does rickets cause sweating?

Rickets is a chronic, nutritional disease characterized by skeletal lesions due to a deficiency of vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism. It is primarily caused by a lack of vitamin D, which can increase neural excitability. Research shows that the vitamin D metabolite, 1,25-dihydroxyvitamin D3, is not only an essential nutrient but also a precursor to hormones. It is potentially related to various cells including those in the thyroid, pancreas, stomach, brain, and those involved with calcium balance, as well as the immune, endocrine, reproductive systems, skin, and tumors. A deficiency in vitamin D can increase myocardial excitability and lead to symptoms like excessive sweating.

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Written by Yan Xin Liang

Pediatrics

53sec

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Does rickets have a hereditary component?

Rickets, also known as vitamin D deficiency rickets, is primarily a chronic nutritional disease characterized by skeletal lesions, caused by insufficient vitamin D in infants, children, or adolescents, which leads to disturbances in calcium and phosphorus metabolism. The main feature of this disease is the incomplete calcification of the growth plates and bone tissue in the growing long bones, due to the lack of vitamin D causing incomplete calcification of mature bones. This disease is most common in children under two years old. Its causes may be related to insufficient intake of vitamin D or insufficient sunlight exposure, as well as rapid growth. Additionally, other diseases may influence its development. Therefore, this disease is generally not closely related to genetics.

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Written by Li Jiao Yan

Neonatology

1min 47sec

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What are the symptoms of rickets?

The condition generally referred to as rickets is most commonly nutritional vitamin D deficiency rickets, a type of nutritional disease that is prevalent among infants and young children, particularly very young babies. It primarily manifests as changes in the bones where growth is most rapid and can also affect muscle development and changes in nervous excitability. Initially, especially within the first three months, symptoms in very young infants typically include increased nervous excitability, such as crying easily, excessive head sweating, and as a result of the sweating, frequent head shaking, irritability, restlessness, and noticeable crying and restlessness at night. These symptoms at this stage are not necessarily indicative of typical rickets. As the condition progresses, changes in the skeleton gradually become apparent. In infants under six months with rickets, the changes are mainly in the skull, typically feeling like pressing on a ping-pong ball. After six months of age, the head shape becomes squared or box-like, and the head circumference is larger than normal. Later, the characteristic beading changes of rickets appear, with beaded protrusions above the ribs, followed by the formation of blunt, circular raised areas at the wrists and ankles, referred to as wrist and ankle bracelets. Around the age of one, infants may develop a deformity resembling pigeon chest. As the child begins to stand and walk, the weight bearing on the lower limbs may lead to deformities, such as bowlegs or knock-knees, and sometimes even K-shaped deformities of the legs, and some might develop spinal deformities.

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Written by Li Jiao Yan

Neonatology

1min 53sec

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How is rickets diagnosed?

Rickets is a chronic nutritional disease caused by a deficiency in vitamin D, which leads to a disruption in calcium and phosphorus metabolism, resulting in abnormal bone development. Typically, the initial symptoms of rickets are most commonly seen 2-3 months after birth. At this stage, affected children often show neurological symptoms such as excessive sweating unrelated to the season, irritability, particularly in infants under three months old who can become easily agitated, and exhibit straining as if constipated, but these are not specific symptoms of rickets. Early diagnosis generally requires specific tests such as blood biochemistry to check the levels of 125 dihydroxy vitamin D3, as well as calcium and phosphorus levels in the blood, and to see if there is any change in serum alkaline phosphatase. The active phase is mainly characterized by skeletal changes, such as early signs of enlarged fontanelles or delayed closure, late teething, and sometimes a softening of the skull resembling a ping-pong ball, gradually leading to a square skull. Subsequently, changes like pigeon chest or noticeable deformities in the lower limbs such as X-shaped legs, O-shaped legs, or K-shaped legs may appear. Sometimes, there may also be curvature of the spine, with occasional scoliosis. These obvious skeletal changes make the condition more recognizable, though the initial presentations are not very typical, necessitating related biochemical blood tests.