How is rickets treated with injections?

Written by Yao Li Qin
Pediatrics
Updated on October 28, 2024
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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 Yao Li Qin
Pediatrics
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The main manifestations of rickets in the early stage

Rickets generally refers to vitamin D deficiency rickets, mainly due to insufficient vitamin D in children, leading to calcium and phosphorus metabolism disorders. It is a chronic nutritional disease characterized by skeletal lesions. The main manifestations are changes in the fastest growing parts of the skeleton, which can also affect muscle development and changes in neural excitability. The initial symptoms of rickets are common in infants, especially those under three months old. The main symptom is increased neural excitability; the child is particularly prone to being agitated, irritable, crying, sweating, and shaking their head due to scalp stimulation, but these are not specific symptoms of rickets. Therefore, blood tests are still necessary in the early stages, showing decreased levels of 25-hydroxyvitamin D3, blood calcium, and blood phosphate, increased PTH, normal or slightly elevated alkaline phosphatase activity, and normal or slightly blurry calcification zones in skeletal X-rays. These are the early manifestations of rickets.

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Written by Zeng Hai Jiang
Pediatrics
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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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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 Huang Kun Mei
Pediatrics
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Symptoms of rickets in infants and young children

The symptoms of rickets in infants and young children mainly include excessive sweating, night terrors, thinning hair at the back of the head, rib cage flaring, pigeon chest, bow legs, and knock knees, among others. If a child exhibits the above symptoms, it is necessary to promptly test for trace elements and check bone density to see if the child has symptoms of calcium deficiency. If so, it is crucial to supplement the child with vitamin D and calcium. In terms of diet, it is necessary to enhance the child's nutrition and increase outdoor activities. Ensure that the child engages in outdoor activities for more than two hours each day, particularly between 12 PM and 2 PM. Avoid exposing the child to sunlight during this time to prevent sunburn, especially to the child's eyes.

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Written by Zhang Xian Hua
Pediatrics
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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.