Question

How is rickets treated?

Answer

Rickets is a common childhood illness, caused by a deficiency of vitamin D in the body that leads to abnormal calcium and phosphorus metabolism, preventing calcium salts from normal deposition in the growth areas of bones, which can ultimately result in skeletal deformities. Although rickets rarely directly threatens life, its onset is slow and often overlooked. Once significant symptoms appear, children may have weakened resistance and may be accompanied by other diseases such as pneumonia, diarrhea, and anemia. The main reasons for vitamin D deficiency are insufficient intake of vitamin D from food or insufficient ultraviolet light exposure, which prevents 7-dehydrocholesterol in the skin from converting to cholecalciferol (vitamin D3). Additionally, rapid growth may also increase the demand for vitamin D. Clinical manifestations of rickets include:

  1. General symptoms: such as excessive sweating, especially during feeding and crying; irritability, love to cry and fuss, and restless sleep at night.
  2. Skeletal changes: such as an enlarged fontanelle, delayed teething, softening of the skull; square or saddle-shaped head; the chest may have costochondral beading, upper costal indentation, costal eversion forming Hesselbach’s groove; and possible appearance of pigeon chest or funnel chest; the distal ends of the ulna and radius may become thickened to form rachitic hand rings; before learning to walk, there may be O-shaped or X-shaped legs. Preventive measures for rickets include increasing outdoor activities, getting more sunlight exposure, trying to breastfeed, and starting daily oral vitamin D supplementation of 400 units at 2 weeks after birth. If the child consumes 400-500 milliliters of milk daily, additional calcium supplementation is not necessary.