Rickets is a disorder of
infancy and early childhood of multiple etiologies. Rickets, causing soft
bones, may occur if enough vitamin D is not present to assist in
calcium absorption. When enough calcium is not absorbed by the bone, it
does not harden properly, and is too soft to support the weight of the
growing body properly. The disease of rickets takes its name from the
Greek word for spine, rhakhis.
Vitamin D is made by the
body when it is exposed to ultraviolet light (sunlight). Vitamin D is
also added to milk, milk products, and multi-vitamin pills. Some people
who do not get enough sun exposure, milk products, or green vegetables
may also develop the disease. Deficiency of calcium can also cause
rickets, particularly in some developing countries where the intake of dairy
products is low.
Hereditary rickets, is
caused by an inherited disease that interferes with the resorption of
renal tubular phosphate in the kidney. Rickets can also be caused by
certain liver diseases.
A similar disorder can
occur in adults, and is called osteomalacia. Then, it is caused by the
inability of bone cells to calcify, or harden. Less frequently,
nutritional shortage of calcium or phosphorus may produce rickets.
Manifestations of disease
Rickets causes bone pain,
slowed growth in children, dental problems, muscle loss and increased
risk of fractures (easily broken bones). Medical problems seen in
children with rickets are
1. Vitamin D deficiency,
2. Skeletal deformity,
3. Growth disturbance,
4. Hypocalcemia (low level of calcium in the blood),
5. Tetany (uncontrolled muscle spasms).
The X-ray, or radiograph,
in the article is the classic image of advanced rickets sufferers: bow
legs (outward curve of long bone of the legs) and a deformed chest.
Changes in the skull also occur causing a distinctive "square
headed" appearance. These deformities persist into adult life.
Treatment and prevention
increasing dietary intake of calcium, phosphates and Vitamin D.
Exposure to sunshine, cod liver oil, halibut-liver oil, and viosterol
are all sources of vitamin D.
A sufficient amount of
sunlight each day and adequate supplies of calcium and phosphorus in
the diet can prevent rickets. Darker-skinned babies need to be exposed
longer to the ultraviolet rays. The replacement of Vitamin D may
correct rickets using these methods of ultraviolet light and medicine.