Rickets is a softening and weakening of the bones due to nutritional deficiency. The most common cause of rickets is a prolonged vitamin D deficiency, although a lack of adequate calcium and phosphate can also lead to the development of rickets. Rickets is most likely to develop during the ages of 6 and 24 months, when bone growth is rapid and the needs for calcium and phosphate are highest.
Physiology of Bone Growth
During periods of growth, your body breaks down old bone to create new bone in its place. To ensure that newly formed bone is healthy and strong, calcium and phosphate come together to form a structure called hydroxyapatite. Vitamin D is also essential in bone formation because this vitamin allows you to absorb calcium and phosphate efficiently. If a child does not consume adequate amounts of vitamin D, calcium and phosphate, the bloodstream will not contain enough calcium and phosphate to form strong bones, so hormones will signal the bones to release calcium and phosphate into the blood. Over time, this softens and weakens the bones.
Symptoms
One of the most common symptoms of rickets is bone pain and tenderness, especially in the arms, legs, pelvis and spine. Children with rickets also experience loss of muscle strength, weakness, holes in tooth enamel and increased incidence of cavities. Rickets can also cause stunted growth and an increased amount of bone fractures. Prolonged rickets can lead to skeletal deformities such as bowed legs, protruding ribcage, abnormal spinal curvature and pelvic deformities. If not promptly treated, skeletal deformities can be permanent.
Treatment
Most cases of rickets can be treated with nutritional supplementation. Replacing lost vitamin D, calcium and phosphorus can help reverse most symptoms and restore bone health. Exposure to sunlight, which allows your body to synthesize vitamin D, is also recommended. Braces may be necessary to prevent skeletal deformities from forming during the healing process. If skeletal deformities are already apparent, corrective surgery may be necessary.
Prevention
Rickets is fully preventable. To prevent rickets, make sure your child receives enough vitamin D, calcium and phosphorus in his diet. The best dietary sources of vitamin D include fortified milk and fish, which also contain significant amounts of calcium. The main food sources of phosphorus include milk and meat. A meal plan that contains adequate amounts of calcium generally offers plenty of phosphorus as well.
