Rickets – Paediatric Osteomalacia : Bone Disease : Tests & Treatment

Rickets is a softening of bones in children due to deficiency or impaired metabolism of vitamin D, magnesium, phosphate or calcium, potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries.

Tests & Diagnostics

A physical exam reveals tenderness or pain in the bones, rather than in the joints or muscles.
The following tests may help diagnose rickets:

  1. Arterial blood gases
  2. Blood tests (serum calcium)
  3. Bone biopsy (rarely done)
  4. Bone x-rays
  5. Serum alkaline phosphatase
  6. Serum phosphorus

Other tests and procedures include the following:
(a) ALP (alkaline phosphatase) isoenzyme
(b) Calcium (ionized)
(c ) PTH
(d) Urine calcium

Treatments

The goals of treatment are to relieve symptoms and correct the cause of the condition. The cause must be treated to prevent the disease from returning.

Replacing calcium, phosphorus, or vitamin D that is lacking will eliminate most symptoms of rickets. Dietary sources of vitamin D include fish, liver, and processed milk. Exposure to moderate amounts of sunlight is encouraged. If rickets is caused by a metabolic problem, a prescription for vitamin D supplements may be needed.

|Positioning or bracing may be used to reduce or prevent deformities. Some skeletal deformities may require corrective surgery.

Complications

  1. Chronic skeletal pain
  2. Skeletal deformities
  3. Skeletal fractures, may occur without cause

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