What are the symptoms of rickets?

Written by Li Jiao Yan
Neonatology
Updated on December 08, 2024
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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
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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 Li Jiao Yan
Neonatology
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Can rickets be treated by injection?

Rickets is primarily caused by a deficiency of vitamin D, leading to a disturbance in calcium and phosphorus metabolism in the body, which results in abnormal bone development. It is a systemic nutritional and chronic disease. The main treatment is to supplement a sufficient dosage of vitamin D, generally administered orally. The choice of vitamin D formulation, dosage, duration of treatment, whether it is administered once or multiple times, and whether supplementation is oral or intramuscular, should be determined based on the specific situation of the child. Relevant tests are generally required, and the doctor will develop a treatment plan based on the child's condition. The route of administration should also be decided based on the condition of the disease.

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Written by Li Jiao Yan
Neonatology
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Is rickets easy to treat?

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 Tong Peng
Pediatrics
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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
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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.