Rickets is a major health problem worldwide, especially in developing countries wherein nutritional deficiencies in children are widespread. In fact, an estimate from the Center for Disease Control and Prevention shows that 5 out of every 1,000,000 children aged between 6 months and 5 years develop Rickets.
Vitamin D deficiency is the leading cause of Rickets. Vitamin D is an essential vitamin that can be synthesized from our skin when there is adequate sunlight exposure. It can also be taken from our diet by the intake of foods such as eggs, milk and fish. Its main role in the body is to facilitate the proper absorption of calcium and phosphorus, both important constituents of bone, from the gastrointestinal tract after a meal. A deficiency of vitamin D, then, triggers certain compensatory mechanisms by the body in which hormones trigger the release of calcium and phosphate from the bone in order to maintain its normal serum levels. This leads to the deficient mineralization and architectural disruption of the bones at the growth plate or epiphysis as manifested by weakened bones, stunted growth and skeletal deformities.
Signs and Symptoms of Rickets
As mentioned above, deficient mineralization at the growth plate in Rickets leads to architectural disruption and bony deformities. The following signs and symptoms may then be observed:
- Pectus Carinatum or pigeon chested
- Craniotabes or having soft skull bones
- Rachitic rosary or having an enlargement of the cartilaginous joints at the sternal end of the ribs
- Harrison’s sulcus or having a prominent bone at the area where the diaphragm should be
- Dental hypoplasia or when the enamel in the teeth is thin and deficient in amount
- Delayed closure of fontanelles
- Bowing of legs
- Swelling in wrist and ankle joints
- Stunted growth
- Bone tenderness
- Brittle bones or bones that may break easily
- Low calcium blood levels
Risk Factors for Rickets
Factors that increase the risk of developing Rickets include the following:
- Young age – Children, especially between 3 to 36 months old, are most at risk as they are experiencing a period of rapid growth
- Malnutrition – Inadequate intake of fish, eggs and milk lead to a vitamin D poor diet
- Poverty
- Inadequate sunlight exposure
- Darker skin color – it predisposes one to develop Rickets as it will take more sunlight exposure to produce vitamin D
- Genes – Hereditary Rickets can limit the ability of the kidneys to retain phosphate
Treatment of Rickets
Being a nutritional disorder, the main approach in the treatment of Rickets involves the replacement of the lacking vitamin or minerals in the body. The following may be done:
- Increased dietary intake of calcium, phosphate and vitamin D by incorporating more of the following in the diet:
- Fish
- Fish oils
- Eggs
- Milk
- Liver
- Adequate skin exposure to mid-day sunlight
- Calcium and Vitamin D supplementation
- If skeletal deformities are present, a brace or corrective surgery may be recommended
- Hereditary Rickets may entail the use of phosphorus medications and active vitamin D hormones
Understanding rickets can help when taking First Aid Courses.
Rickets is a nutritional disorder manifested by the weakening of bones in children due to the inadequate mineralization needed for normal bone growth.