Rickets and osteoporosis are caused by a lack of what?

Written by Zeng Hai Jiang
Pediatrics
Updated on March 05, 2025
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Rickets and osteoporosis are both caused by a lack of vitamin D and calcium. Rickets is commonly seen in infants and can present with abnormalities in skeletal development such as "ping-pong ball head", signs of wrist and ankle bracelets, square skull, funnel chest, pigeon chest, X-shaped legs, and O-shaped legs. Osteoporosis is a metabolic bone disease caused by reduced bone formation and increased bone resorption. It can be categorized according to its etiology into senile osteoporosis, postmenopausal osteoporosis, idiopathic osteoporosis, and secondary osteoporosis. Clinically, it can manifest as fatigue, bone pain, and fractures.

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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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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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How is rickets treated with injections?

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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What are the symptoms of rickets?

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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Can rickets be cured?

Rickets refers to a nutritional disease characterized by bone lesions caused by disorders in calcium and phosphorus metabolism due to a deficiency of vitamin D in the body. The primary treatment for rickets involves early detection and comprehensive treatment at an early stage, which is crucial. The general treatment goal is to control the active phase, prevent deformities, and avoid recurrence. Nutritional rickets due to a deficiency of vitamin D is a self-limiting disease; it can be cured once infants and young children engage in sufficient outdoor activities and supplement with vitamin D. Early detection of low vitamin D levels or abnormalities in calcium and phosphorus metabolism, along with early proactive intervention, can prevent the occurrence of skeletal deformities. If sequelae are present, there is no need for medication; mild to moderate cases should strengthen physical exercise, and skeletal deformities can be corrected through active or passive rehabilitation movements. Severe skeletal deformities can be corrected through surgical treatment.