Rickets causes the bones of the affected children to become weak and soft. Weakening and softening of the bones causes them to become fragile which in turn makes it more susceptible to fractures . Soft and weak bones also cause poor growth and development in affected children. In such conditions, the child is shorter than average.
Pain may set in which may cause the child to become tired easily. Such children also experience difficulty while walking. Dental problems may develop including delay in teeth occurrence and the child is more susceptible to develop cavities.
A preliminary physical examination is done to evaluate for the signs and symptoms of bone tenderness and presence of associated abnormalities. In addition, further tests are required to confirm the diagnosis of rickets. These tests include:
In majority of the cases, rickets can be corrected by administration of vitamin D and calcium supplements. In many cases, single day dose therapy is considered wherein 600,000 IU of Vitamin D is administered . In the gradual dose method, about 5000 to 10,000 IU of vitamin D is administered every day for a period of 2 to 3 months. It is necessary to carefully follow the dosage schedule as prescribed by the doctor. This is so because excessive administration of vitamin D can have deleterious effects on the body .
The prognosis of the condition is usually favorable with timely initiation of treatment. When minerals and Vitamin D are supplemented during the early stages of the disease then skeletal deformities gradually get corrected. It has been seen that administration of adequate doses of vitamin D and minerals show an improvement in laboratory value and bone X-ray of the affected individuals. However, failure to initiate treatment can cause permanent skeletal deformities to set in.
Deficiency of vitamin D, calcium and phosphorus causes development of rickets amongst children and adolescents. Deficiency of these nutrients occurs in population who live in climates where they are little exposed to sunlight or in those who prefer to stay indoors. Children who are intolerant to lactose also exhibit vitamin D deficiency. Children who follow a strict vegetarian diet are also susceptible to develop deficiency of vitamin D which if continues for long term can cause rickets . Heredity is yet another factor that can lead to the disorder. In addition, children who have renal tubular acidosis are also likely to suffer from the condition .
Rickets is a common occurrence in infants who are only breastfed and are dark skinned. However, in developed countries the incidence is low and is estimated to be 1 in 200,000. In developing countries, rickets was a common occurrence in the past; however the incidence of the condition decreased due to fortification of foods with vitamin D since the year 1940 .
Vitamin D plays a vital role in regulating the calcium and phosphorus levels. In conditions when the levels of these mineral decrease significantly, the body in response produces hormones that causes the calcium and phosphorus to be released from the bones . This in turn leads to softening and weakening of the bones, causing development of rickets  .
Rickets can be prevented by ensuring proper intake of vitamin D from the diet. Parents are also advised to encourage their children to play outdoors so that they can adequately get exposed to sunlight.
Children with underlying disease conditions governing the kidneys should be promptly treated. This is because poor renal functioning interferes with appropriate absorption of vitamin D causing rickets. In addition, children with gastrointestinal disorders or other diseases should be given supplements of vitamin D and calcium .
Children who are only breastfed often fall prey to rickets because breast milk does not contain sufficient amounts of vitamin D. In many cases, rickets also result due to deficiency of calcium and phosphorus . It has been reported that rickets was the first childhood disease that was caused due to industrial pollution. During the era of industrial revolution, rickets outbreak occurred in the temperate zone because the pollutants from the factories blocked the sun rays. This led to development of vitamin D deficiency in the population.
Rickets is a condition characterized by development of weak and soft bones due to vitamin D deficiency. Inadequate level of vitamin D causes calcium and mineral from the bones to be released that ultimately results in weakening of the bones. Incidence of rickets has undergone a significant decline in developed as well as developing countries due to introduction of foods fortified with vitamin D.
Lack of vitamin D causes rickets. Children who play indoors are not exposed to sunlight which devoid them of sun rays. A diet that is deficient in calcium and vitamin D can also lead to development of rickets. Heredity is yet another factor that is known to play foul. Children or adolescents suffering from kidney disorders are also susceptible to develop rickets.
Symptoms of rickets include pain in spine, legs, development of muscle weakness and delayed growth. In many cases structural deformities such as bow legs, projection of breastbone and thickening of the wrists and ankles can also set in.
Diagnosis of rickets includes conducting blood tests to evaluate levels of calcium, phosphorus and vitamin D. Arterial blood gas measurement along with bone X-rays are also conducted.
Treatment of rickets includes administration of vitamin D supplements to correct the condition. Single dose therapy or gradual dose is given for patients with rickets. Surgery is often the last resort which is employed when there are severe structural deformities.