Rickets

DEFINITION

Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency.

Vitamin D promotes the absorption of calcium and phosphorus from the gastrointestinal tract. A deficiency of vitamin D makes it difficult to maintain proper calcium and phosphorus levels in bones, which can cause rickets.

If a vitamin D or calcium deficiency causes rickets, adding vitamin D or calcium to the diet generally corrects any resulting bone problems for your child. Rickets due to a genetic condition may require additional medications or other treatment. Some skeletal deformities caused by rickets may need corrective surgery.

CAUSES

Your body needs vitamin D to absorb calcium and phosphorus from food. Rickets can occur if your child’s body doesn’t get enough vitamin D or if his or her body has problems using vitamin D properly.

Lack of vitamin D

You receive vitamin D from two sources:

• Sunlight. Your skin produces vitamin D when it’s exposed to sunlight. But children in developed countries now tend to spend less time outdoors. They’re also more likely to use sunscreen, which blocks the rays that trigger the skin’s production of vitamin D.
• Food. Fish oils, fatty fish and egg yolks contain vitamin D. Vitamin D also has been added to some foods, such as milk, cereal and some fruit juices. Children who don’t eat enough of these fortified foods can develop a vitamin D deficiency.

Problems with absorption

Some children are born with or develop medical conditions that affect the way their bodies absorb vitamin D. Some examples include:

• Celiac disease
• Inflammatory bowel disease
• Cystic fibrosis
• Kidney problems

SYMPTOMS

Signs and symptoms of rickets may include:

• Delayed growth
• Pain in the spine, pelvis and legs
• Muscle weakness

Because rickets softens the growth plates at the ends of a child’s bones, it can cause skeletal deformities such as:

• Bowed legs
• Thickened wrists and ankles
• Breastbone projection

When to see a doctor

Talk to your doctor if your child develops bone pain, muscle weakness or obvious skeletal deformities.