Page Contents
OVERVIEW
Rickets is a bone disorder in growing children that is characterized by deficient calcification of the growth plate.
WHAT CAUSES IT?
Vitamin D or calcium deficiency is often the cause of this condition.
WHAT MAKES US SUSPECT IT?
Risk Factors:
Dark skin complexion, exclusive breastfeeding, inadequate sun exposure, maternal vitamin D deficiency
Initial Presentation
Physical Exam:
HEENT:
- Craniotabes (ping-pong ball skull)
- Delayed fontanel closure/enlarged anterior fontanel
Musculoskeletal:
- Chostochondral joint hypertrophy (rachitic rosary)
- Long bone joint enlargement (wrist widening)
- Bowed legs (genu varum)
CLINICAL WORKUP
Serum laboratory findings:
- Calcium: normal/decrased
- Phosphorous: normal/decreased
- Alkaline phosphatase: increased
- Parathyroid hormone: increased
- 25-OH vitamin D: decreased
X-Ray imaging can show specific features of osteopenia, metaphysical cupping/fraying/epiphyseal widening
HOW DO WE PREVENT IT?
Vitamin D supplementation: babies who do not eat a vitamin D fortified baby formula can receive vitamin D supplementation to prevent rickets. While breast milk is the gold standard for nutrition in children < 1 age, it does not have adequate vitamin D.
ARCHIVE OF STANDARDIZED EXAM QUESTIONS
This archive compiles standardized exam questions that relate to this topic.
Page Updated: 11.22.2016