How to prevent skeletal deformities in rickets

Written by Wang Xiao Jing

Pediatrics

Updated on January 12, 2025

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Rickets is mainly caused by a deficiency of vitamin D. Therefore, within half a month after a child's birth, a preventive dose of oral vitamin D should be administered. Continue breastfeeding, allow the baby to get plenty of sunlight when the weather is warm, and timely introduce calcium-rich supplementary foods. In the early and active stages of rickets, appropriate supplementation with calcium and vitamin D can prevent the occurrence of skeletal deformities caused by the disease.

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Written by Li Jiao Yan

Neonatology

52sec

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What department should I see for rickets?

Rickets is a nutritional disease caused by a deficiency of vitamin D, which leads to a disorder of calcium and phosphorus metabolism and consequently abnormal bone development. In the early and active stages of rickets, the main symptoms are low levels of vitamin D and disordered calcium and phosphorus metabolism. At this stage, bone development abnormalities may not be clearly noticeable, so it is recommended to consult an endocrinology department. During the residual stage, when skeletal deformities appear, rehabilitation treatment is necessary, and consultation with a pediatric rehabilitation department is advisable. Severe skeletal deformities may require surgical correction, necessitating consultation with an orthopedic department.

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Written by Li Jiao Yan

Neonatology

1min 53sec

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How is rickets diagnosed?

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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Written by Li Jiao Yan

Neonatology

1min 25sec

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Early symptoms of rickets

Rickets is a chronic systemic nutritional disease caused by insufficient vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism, characterized by skeletal lesions, typically presenting as incomplete mineralization of the long bones' growth plates and bone tissue. In the early stages of rickets, skeletal development abnormalities are not very obvious. Infants under three months often exhibit signs of increased neural excitability, such as being prone to crying, sweating easily, and potentially frequent head shaking; however, these symptoms are not necessarily specific to rickets. Generally, at this time, there are no obvious abnormalities in skeletal development, and X-rays of the bones are normal. The focus is on vitamin levels, specifically decreased serum 25-hydroxy vitamin D, as well as reduced blood calcium and phosphorus levels. Therefore, early symptoms are not so typical. It is recommended that children regularly visit pediatric clinics for physical examinations to assess their development and, if necessary, undergo trace element and vitamin D level checks.

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Written by Tong Peng

Pediatrics

56sec

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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 Li Jiao Yan

Neonatology

1min 24sec

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Rickets Causes

Rickets, fully termed as nutritional vitamin D deficiency rickets, is a chronic systemic nutritional disease characterized by epiphyseal lesions, caused by insufficient vitamin D in children, leading to disordered calcium and phosphate metabolism. The main causes of the disease include insufficient perinatal vitamin D, particularly during the prenatal and postnatal periods, as well as factors like severe maternal malnutrition, liver and kidney diseases, chronic diarrhea, prematurity, and having twins, which may lead to inadequate levels of vitamin D storage in the body. Additionally, insufficient sunlight exposure, such as children spending prolonged periods indoors, blocks sunlight, as ultraviolet rays cannot pass through glass. Ultraviolet light aids in the synthesis of endogenous vitamin D; lack of exposure can also reduce vitamin D levels. Another factor is rapid growth rates, and fourthly, insufficient dietary supplementation of vitamin D along with some diseases that affect the absorption of vitamin D, like gastrointestinal or liver and biliary diseases.