Rickets – Sign & Symptoms, Cause & Treatment


What is rickets?

Rickets refer to deficient mineralization at the growth plate/ physis (growing area found at the end of the bone)

What are the common signs & symptoms of Rickets?

Rickets occurs in young children, so it mainly affects bony growth & development. In this problem, a child will have
Delayed & slow bone growth,
muscle weakness & cramp,
pain and tenderness in the bone of spine, pelvis & leg,
short stature
fracture with trivial trauma
rachitic rosary in chest wall– Enlargement of the costochondral junction
Harrison sulcus- the prominence of lower rib margin
Swelling in wrist,, knee
Deformity of limb -like bow leg, genu valgus, femur, radius deformity, etc
A dental problem like- delayed tooth formation, dental abscess, dental cavity, defect in a tooth, etc

What Causes Rickets?

Rickets occurs due to deficiency of vitamin D, Calcium & phosphorus. Vitamin D deficiency mainly occurs because of nutritional deficiency and lack of exposure to sunlight. Other causes are familial, genetic diseases, kidney disease, intestinal disease & liver problems, etc.

How to diagnose the Rickets?

Rickets can be identified by clinical examination of the child. X-ray of deformed limbs is required to see the impact of vitamin D on bone. A low level of Vitamin D, calcium-phosphorus in blood will confirm the diagnosis of Rickets. In familial & genetic causes, vitamin D levels may be normal or more down. So other investigation, including 24-hour urine assessment, is required.

What is the Prevention?

Rickets can be prevented by taking foods fortified with vitamin d, 30-40 minute exposure to sunlight in a week, and vitamin D, Calcium supplement to the high-risk group.

What are the risk factors?

Dark skin, Wearing sunscreen outdoor, on lactose-free diet / strict plant-based diet, spend a lot of time indoors/ Don’t get enough exposure to sunlight. Don’t eat enough foods containing vitamin D, calcium, or phosphorus. Breastfeed without getting a vitamin D supplement. Have an illness that prevents their body from making or absorbing vitamin D like celiac disease, kidney disease & liver problem, premature born children & infant born to Vit. D deficient mother, hereditary metabolic disease Live in a place with a high level of air pollution.

What is Rickets treated?

Treatment of Rickets is vitamin D, Calcium, phosphorus supplement. A pediatrician/pediatric orthopedic surgeon decides the dose. Mild to moderate limb deformity will be corrected spontaneously, but moderate to severe deformity may need bracing and orthopedic surgery. In rare cases of phosphorus deficiency rickets, we need to supplement phosphorus along with calcium & vitamin D.


Leg Deformities X-Ray - 1
Limb Deformities X-Ray - 2

Frequently Asked Questions

What are the major complications in rickets?

Failure to growth, an abnormally curved spine, Bone deformities, Dental defects, Seizures are major complications in rickets.

What are the major factors that can increase the risk of rickets in child?

Mother’s vitamin D deficiency during pregnancy, premature birth, and exclusive breastfeeding, lack of sun experience & nutritional deficiency are common factors.

How to make diagnosis of rickets?

It can easily identify through clinical examination. Vitamin d level in blood and x-ray of limbs will confirm the diagnosis.

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Dr. Jitendra Kumar Jain is a famous name in the field of childhood physical disability pediatric orthopedic problems in North India. He has been an MS Orthopedics, DNB Orthopedics, Pediatric orthopedic surgeon & also a cerebral palsy specialist for over 21 years.

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