Rickets

Definition

Rickets is a rare bone disease. It causes bones to soften and weaken.

Rickets

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Causes

Rickets is caused by a lack of vitamin D, calcium, or phosphate in the body. This may happen due to:

  • Lack of sun exposure so the body cannot create vitamin D
  • Not eating enough foods with vitamin D, calcium, or phosphorous
  • Problems in the body that prevent it from absorbing vitamin D, calcium, or phosphate
  • Genetic problems, such as vitamin D-resistant rickets

Risk Factors

Rickets is more common in children who:

  • Are 6 to 24 months of age
  • Have darker skin

Other things that may raise the risk are:

  • Breastfeeding without vitamin D supplementation
  • Lack of sun exposure
  • Vegetarian diet without vitamin supplements
  • Malabsorption syndromes, such as Celiac disease or cystic fibrosis
  • Being born very early
  • Having a mother with vitamin D deficiency during pregnancy
  • Drugs that affect vitamin D, calcium, or phosphorous absorption or use

Symptoms

Problems may be:

  • Muscle weakness
  • Bowed legs
  • Bone pain in the back, pelvis, and legs
  • Seizures
  • Muscle spasms
  • Skeletal and/or skull deformities

Diagnosis

You will be asked about your child's symptoms and health history. A physical exam will be done. This may be enough to suspect rickets.

The diagnosis may be confirmed with:

Treatment

The underlying cause will need to be treated. The goals of treatment are to relieve or reverse symptoms.

Vitamin D, calcium, or phosphate supplements will be given. Children with severe symptoms may need surgery to correct bony deformities.

Prevention

To lower the risk of rickets:

  • Encourage children to eat foods that are high in calcium and vitamin D.
  • Allow some exposure to sunlight. Fifteen minutes a day is usually enough. Any longer than that requires sun protection.
  • Breastfed babies and bottle-fed babies who do not get enough vitamin D fortified formula may need to be given a supplement.

RESOURCES:

Eat Right—Academy of Nutrition and Dietetics
http://www.eatright.org
Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

CANADIAN RESOURCES:

The Hospital for Sick Children—About Kids Health
http://www.aboutkidshealth.ca

References:

Mughal MZ. Rickets. Curr Osteoporos Rep. 2011 Dec;9(4):291-299.
Rickets. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/rickets. Accessed December 1, 2020.
Rickets. Family Doctor—American Academy of Family Physicians website. Available at:
...(Click grey area to select URL)
Accessed December 1, 2020.
Vitamin D deficiency in children (infancy through adolescence). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/vitamin-d-deficiency-in-children-infancy-through-adolescence. Accessed December 1, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 4/23/2021

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