How to diagnose rickets?

Written by Li Jiao Yan
Neonatology
Updated on September 01, 2024
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Rickets is caused by a deficiency of vitamin D, which leads to abnormal calcium and phosphorus metabolism, and thus abnormal bone development. Generally, rickets requires biochemical blood tests and vitamin D level assessments, followed by skeletal X-ray examinations. However, some cases of rickets are caused by other special reasons, such as abnormalities in liver and kidney functions, and there may also be congenital genetic diseases. Therefore, rickets also requires further related examinations, such as liver function tests, kidney function tests, and parathyroid hormone tests, and even some genetic level examinations might be conducted.

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Written by Yao Li Qin
Pediatrics
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Causes of Rickets

Rickets, also known as Vitamin D-deficiency rickets, implies from its name that the cause of the disease is due to insufficient intake of Vitamin D in children, leading to disorders in calcium and phosphorus metabolism and resulting in nutritional disease with skeletal deformities. The incidence of the disease is higher in the north than in the south. Currently, the incidence of mild and moderate rickets is relatively high, while severe cases are less common because people are increasingly paying attention to the supplementation of Vitamin D for children. It is recommended that full-term infants start supplementing with 400 units of Vitamin D daily two weeks after birth, which is the physiological requirement. For premature infants, twins, and extremely low birth weight infants, the daily physiological requirement of supplementation is 800 units per day. After supplementing continuously for three months, it should be adjusted to 400 units per day as per the requirement for full-term infants. With such management, the child will not suffer from rickets. However, if there is no regular supplementation after birth, the lack of Vitamin D can lead to skeletal changes in the child, and once rickets is diagnosed, it requires high doses of supplementation.

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Written by Li Jiao Yan
Neonatology
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Can rickets be cured?

Can rickets be cured? Rickets is a type of nutritional disease caused by a deficiency of vitamin D, which disrupts the body's calcium and phosphorus metabolism and leads to abnormal bone development. The common form is nutritional vitamin D deficiency rickets. This type of disease is self-limiting and can be cured. Once children engage in sufficient outdoor activities and supplement their vitamin D levels, they can be completely cured. There are also some special cases, such as severe liver and kidney diseases caused by vitamin D deficiency, and some genetic diseases. These diseases require treatment to promote the absorption of vitamin D. However, for genetic diseases, treating rickets with vitamin D is ineffective, and these cases are more difficult to treat. For liver and kidney diseases, if the condition can be effectively controlled, they can also be cured.

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Written by Yao Li Qin
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How is rickets treated with injections?

Rickets, also known as vitamin D deficiency rickets, is a chronic nutritional disease characterized by skeletal lesions, caused by insufficient vitamin D in children, leading to disturbances in calcium and phosphorus metabolism. The typical manifestation of rickets is incomplete mineralization of the growing long bone epiphyses and bone tissue, presenting as bone softening or deformity. Once rickets is diagnosed, it must be treated aggressively. First, children are given high doses of vitamin D, either orally or through intramuscular injection, with a common practice of administering a single dose of 300,000 units of vitamin D intramuscularly. A month later, a blood sample is taken to measure the vitamin D content; if it is below normal, treatment must continue; if it is within the normal range, it is only necessary to supplement the daily physiological requirement of vitamin D for the child. (Specific medication should be administered under the guidance of a physician.)

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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.

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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.