Rickets is a severe bone disorder in children, prevalent in 1.7 per 100,000 children globally, according to studies. It causes soft, weak bones due to a lack of essential minerals like vitamin D, calcium, and phosphate. These nutrients are crucial for healthy bone growth, and when the body doesn’t properly absorb them, it disrupts normal bone development. 

Over time, this can cause serious issues such as stunted growth, skeletal deformities, and long-term health complications. Understanding the mechanisms behind this disorder is crucial for early detection. Keep reading to learn about the causes, symptoms, prevention, and effective management of rickets in children.

What is Rickets?

Rickets is a skeletal disease in children caused by chronic insufficiency of vitamin D, calcium, or phosphate. These minerals are necessary for adequate bone mineralisation, and their low levels interfere with the normal process of bone building.

The intricacy of rickets disease is more than just nutritional insufficiency. It is a condition that involves several aspects, and it compromises the body’s capability to adequately develop and maintain bone structure.

What are the Causes of Rickets?

The causes of rickets are diverse and interconnected. They include nutritional, genetic, and environmental factors. Understanding these causes is crucial for effective prevention and treatment:

• Vitamin D Deficiency: Lack of sunlight exposure is the most common cause of Rickets. Vitamin D is essential for calcium absorption and bone strength. High-risk groups for vitamin D Deficiency:
  • Children in regions with limited sunlight.
  • Individuals with darker skin tone (reduced UVB absorption).
  • Individuals with minimal outdoor activity.
• Nutritional Factors: Diets insufficient in vitamin D and calcium contribute to weak bones. Poor nutrition can lead to long-term skeletal issues. Common deficiencies include:
  • The diet lacks fatty fish, egg yolks, or fortified dairy.
  • Inadequate calcium intake from leafy greens or dairy.
• Genetic Conditions: These genetic conditions affect the body’s ability to absorb or process vitamin D, calcium, and phosphate:

• Vitamin D-Dependent Rickets (VDDR)
• X-Linked Hypophosphatemic Rickets (XLH)
• Hereditary Hypophosphatasia
• Medical Complications: Chronic illnesses that impact nutrient absorption can lead to rickets. High-risk conditions include:
  • Celiac disease
  • Inflammatory bowel disorders
  • Kidney diseases affecting calcium-phosphate balance

What are the Risk Factors of Rickets?

There are several risk factors that arise due to the effect of rickets. Understanding these helps in early intervention and prevention:

• Dark Skin Pigmentation: Higher melanin levels reduce the skin’s ability to produce vitamin D from sunlight. That is why individuals with darker skin need more sun exposure to generate adequate vitamin D.
• Exclusive Breastfeeding without Supplementation: Breastfeeding is healthy for babies, but breast milk alone doesn’t have enough vitamin D. Babies who are exclusively breastfed without vitamin D drops are more likely to develop rickets.
• Limited Outdoor Activities: Increased screen time and indoor activities reduce sun exposure. Children who spend minimal time outside are at heightened risk of developing rickets.
• Malabsorption Syndromes: Some health conditions make it difficult for the body to absorb vitamin D, calcium, and phosphate, increasing the risk of rickets:
  • Digestive issues: Celiac disease, Crohn’s disease, inflammatory bowel disease (IBD)
  • Chronic illnesses: Kidney disease, liver disorders, cystic fibrosis (affects vitamin absorption)

What are the Symptoms of Rickets?

Rickets symptoms can significantly impact a child’s overall development and physical health. The condition presents through several distinctive physical indicators that parents and healthcare professionals should carefully monitor.

• Delayed Growth: Children with rickets typically experience stunted physical development. Their height and weight may fall below standard growth charts for their age group.
• Skeletal Deformities: Rickets cause noticeable changes in bone structure. Children might develop bowed legs, curved spines, or protruding breastbones, which indicate compromised bone mineralisation.
• Muscle Weakness: Reduced muscle strength is a common symptom of rickets. Children may struggle with physical activities and demonstrate reduced mobility compared to their peers.
• Increased Fracture Risk: Weakened bones become more susceptible to breaks and fractures. Minor impacts that would not typically cause injury can result in bone damage.
• Dental Complications: Children may experience delayed tooth development and an increased risk of cavities due to compromised calcium metabolism.
• Soft Skull Bones: Infants might develop soft or thin skull bones, which can be detected during routine medical examinations.

How to Diagnose Rickets?

Accurate diagnosis of rickets requires comprehensive medical assessment. Healthcare professionals employ multiple diagnostic strategies to confirm the condition.

• Blood Tests: Physicians conduct detailed blood screenings to measure:
  • Vitamin D levels
  • Calcium concentrations
  • Phosphate levels
  • Alkaline phosphatase enzyme activity
• Vitamin D Level Screening: Specific blood tests determine the exact vitamin D concentration in the body. Low levels strongly indicate a potential risk of disease.
• Bone Density Scans: Advanced imaging techniques assess bone mineral content. These scans help evaluate the extent of bone demineralisation and structural changes.
• X-ray Imaging: Radiographic examinations reveal structural bone abnormalities. Some of them include:
  • Widened growth plates
  • Reduced bone density
  • Visible skeletal deformities
• Genetic Testing: In some cases, doctors might recommend genetic screenings to identify inherited metabolic disorders contributing to rickets.
• Nutritional Assessment: Comprehensive dietary evaluations help understand potential nutritional deficiencies causing the condition.

What are the Treatment Options for Rickets?

Rickets treatment involves addressing the root cause and ensuring healthy growth. Doctors take a well-rounded approach to restoring bone health and preventing future issues.

Medical Interventions

Rickets treatments focus on several critical medical approaches:

• Vitamin D Supplementation: Doctors prescribe the right dosage to correct deficiencies and support bone strength.
• Calcium & Phosphate Replacement: Ensures proper bone development, with dosages tailored to individual needs.
• Dietary Guidance: Nutritionists help families plan meals rich in vitamin D, calcium, and other essential nutrients.
• Orthopedic Care: In severe cases, specialists monitor bone development and recommend braces or corrective treatments.

Lifestyle Modifications

Comprehensive rickets treatment extends beyond medical interventions:

• Increased Sunlight Exposure: Safe outdoor activities help boost the body’s natural vitamin D production.
• Healthy Eating: A balanced diet with foods like dairy, fish, eggs, and fortified cereals helps strengthen bones.
• Regular Exercise: Age-appropriate physical activity keeps bones and muscles strong.
• Targeted Physiotherapy: For severe cases, supervised exercises help correct bone structure and movement.

What are the Prevention Strategies for Rickets?

Preventing rickets is about ensuring the body gets enough essential nutrients, staying active, and keeping up with regular health check-ups. Small, consistent lifestyle changes can go a long way toward keeping bones strong and healthy.

Nutritional Recommendations

Proper nutrition plays a crucial role in preventing rickets. The body requires specific nutrients to maintain healthy bone development and mineralisation.

• Adequate Vitamin D Intake
  • Include vitamin D-rich foods like fatty fish, egg yolks, and fortified dairy products.
  • If needed, take supplements as recommended by a doctor.
• Calcium-rich Diet
  • Drink milk and eat cheese, yoghurt, and leafy green vegetables.
  • Opt for calcium-fortified foods and drinks.
• Dietary Supplements
  • Consult a paediatrician or doctor about vitamin D and calcium supplements.
  • Follow the correct dosage based on age and health needs.

Environmental Considerations

Environmental factors significantly influence rickets causes and prevention strategies. Lifestyle and exposure to natural elements can heavily impact bone health.

• Moderate sun exposure
  • Aim for 10-30 minutes of sunlight exposure daily
  • Protect skin from excessive UV radiation
• Outdoor activities
  • Practice regular physical exercise
  • Participate in sports and recreational activities
  • Promote healthy lifestyle habits
• Comprehensive health monitoring
  • Regular medical assessments
  • Early intervention for potential health issues

FAQs about Rickets

1. What are the causes of rickets?

Rickets is majorly caused by severe vitamin D deficiency, insufficient calcium intake, and limited sun exposure.

2. What are the symptoms of rickets in children?

Symptoms of Rickets are soft and weakened bones, skeletal deformities like bowed legs, retarded growth, weakness of muscles, large wrists and ankles, and fractures. Children develop stunted growth and have a characteristic skeletal system in this disease.

3. Who is at high risk for rickets?

High-risk populations for rickets are exclusively breastfed babies without vitamin D supplementation, dark-skinned children, children living in areas with poor sunlight and limited outdoor activities, and those with chronic illnesses that disrupt nutrient uptake.

4. How to prevent rickets in babies?

Preventing rickets in babies involves ensuring adequate vitamin D intake through supplements, moderate sun exposure, and a nutrient-rich diet.

5. Can children with rickets walk?

Children with rickets may experience walking difficulties due to bone weakness and skeletal deformities. Severe cases can cause bowed legs, joint pain, and muscle weakness, which can significantly impact mobility and physical development.

6. Can rickets be cured?

Yes, rickets can typically be reversible with proper medical intervention, particularly when diagnosed early.

Conclusion

Rickets prevention and management require medical knowledge, nutrition awareness, and anticipatory healthcare measures. Families can lower the risk of rickets by handling the causes of rickets with specific dietary modifications, lifestyle changes, and prompt medical evaluation. To access more medical concepts for the NEET PG exam, join DocTutorials’ courses today.