How is rickets diagnosed?

Written by Li Jiao Yan
Neonatology
Updated on October 27, 2024
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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.

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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.

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Written by Zhang Xian Hua
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Is pillow baldness rickets?

Balding at the back of the head is a common clinical manifestation of rickets, but it does not mean that balding at the back of the head is equivalent to rickets, as there are many causes for this condition. In children with rickets, due to a lack of vitamin D leading to calcium deficiency, their neural excitability increases, which can affect the baby's sleep and cause restless sleep leading to balding at the back of the head. However, children who are in poor nutritional condition might also experience deficiencies in trace elements, such as a lack of zinc or iron, which can also lead to sleep disturbances and balding at the back of the head, indicating that the cause may not necessarily be rickets. Additionally, a small number of children might have an inherent condition of increased neural excitability that affects sleep, leading to balding at the back of the head, which also isn't due to rickets. Therefore, if balding at the back of the head occurs, it is advisable to visit a hospital’s pediatric healthcare department or pediatric outpatient clinic for a consultation and check-up, to actively treat and manage based on the underlying cause.

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Can rickets in a 1-year-old baby be cured?

Can rickets in a one-year-old baby be cured? It is advised that parents should first take the baby to a reputable pediatric hospital for a detailed examination. Treatment should be based on the results of the examination. Generally, under normal circumstances, such problems in children are caused by a lack of calcium leading to rickets. With treatment from a doctor, they generally recover completely. Parents can give their child calcium supplements, along with some vitamin D, and ensure the child gets plenty of sunlight exposure. If there is severe joint deformity, surgical treatment along with rehabilitation exercises may be necessary.

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Is a square skull definitely rickets?

Square skull is not necessarily rickets; square skull can be seen in rickets and congenital syphilis, especially common in rickets. It is often seen in children with rickets older than 8-9 months, due to a lack of calcium in the bones which leads to inadequate bone deposition and calcification. Under the periosteum of the child's frontal bone, parietal bone, and occipital bone, a large amount of osteoid deposition forms the square skull. Therefore, while square skull is not necessarily indicative of rickets, it is a common manifestation in rickets.

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Does rickets affect development and intelligence?

Rickets is primarily caused by a deficiency in vitamin D and mainly affects normal growth and development, with very little to no impact on intelligence. In the early stages of rickets, symptoms mainly include irritability, restlessness, and excessive sweating at night. The body primarily exhibits symptoms such as sweating, night terrors, and irritability, with symptoms becoming significantly more pronounced. During this period, the main manifestations are skeletal deformities, which vary in different age groups. For example, there can be softening of the skull, as well as pectus excavatum, pectus carinatum, and X-shaped or O-shaped legs. In severe cases, spinal deformities may also occur.