Is rickets easy to treat?

Written by Li Jiao Yan
Neonatology
Updated on December 13, 2024
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Rickets is primarily a nutritional disease caused by insufficient levels of vitamin D leading to disturbances in calcium and phosphate metabolism, resulting in abnormal bone development. The most common type is nutritional vitamin D-deficiency rickets. This type of disease is self-limiting and thus relatively easy to treat. It requires early detection and proactive intervention. Early measures include encouraging children to engage in outdoor activities and supplementing with appropriate doses of vitamin D, which can effectively treat rickets. However, there are also special causes of vitamin D deficiency such as significant anomalies in liver or kidney function and certain genetic diseases that severely impair vitamin D absorption. When vitamin D treatment is ineffective, it may be due to other special causes. Treatment of rickets under these circumstances can be more challenging, and genetic diseases may respond poorly to treatment.

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Written by Li Jiao Yan
Neonatology
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Which department should I go to for rickets?

Rickets is a nutritional disease caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism and resulting in abnormal bone development. During the early and active stages, the X-ray shows no obvious abnormalities in bone development; it is primarily a conceptual metabolic disorder along with low levels of vitamin D. At this time, it is advisable to consult an endocrinology department. If there are sequelae and mild to moderate sequelae, rehabilitation methods are needed for correction, and at this point, a rehabilitation department should be consulted. If there are severe skeletal deformities, surgical correction may be necessary, and at this time, an orthopedic department should be consulted.

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Written by Yan Xin Liang
Pediatrics
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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
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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 Tong Peng
Pediatrics
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Will the frontal bossing from rickets get better?

Rickets, if presenting with frontal bossing, can recover depending on the specific condition and age of the child. Rickets is often divided into four stages, with sequelae usually occurring after the age of three. Therefore, if symptoms of rickets are present before the age of three, they can be alleviated through supplementation with vitamin D, calcium, and other trace elements. Symptoms of rickets include craniotabes, Harrison's groove, beading of the ribs, pigeon chest, everted ribs, bowlegs, and knock-knees. Frontal bossing is often a manifestation of craniotabes, which usually occurs during infancy. Supplementing with vitamin D during this period can greatly alleviate the condition. At the same time, it is important to also expose the child to sunlight and engage in outdoor activities to promote the bones' absorption of vitamin D and calcium, preventing the recurrence of symptoms.

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Written by Zeng Hai Jiang
Pediatrics
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Rickets are more commonly seen at a few months old.

Rickets often presents with square skull in babies older than 8 to 9 months. A normal baby’s skull is round and without angles. The square skull seen in rickets is due to a calcium deficiency in the bones, leading to poor development of cartilage and inability for bone deposition and calcification. This results in a large amount of osteoid deposition under the periosteum of the frontal, parietal, and occipital bones, thus forming angular shapes and a squared skull. Besides square skull, rickets can also manifest as various other skeletal abnormalities at different ages, including "ping pong ball" skull, funnel chest, pigeon chest, bracelet sign, rosary sign, X-shaped legs, and O-shaped legs.