Rickets is the softening and weakening of bones in children, because of prolonged vitamin D deficiency. It is seen most commonly in children 6-24 months of age Rickets involves development delay or abnormalities of the bones. Rickets causes softening and poor mineralization of the bones, which leads to skeletal deformities.
Vitamin D known as the “sunlight vitamin” because it is made in our skin when we are exposed to sunlight. Vitamin D can also be obtained through dietary sources. Vitamin D is only found naturally in significant levels in a few foods, including fatty fish, cod-liver oil, and eggs. As Vitamin D promotes the absorption of calcium and phosphorus from the gastrointestinal tract. In deficiency of vitamin D there is problem in maintaining proper calcium and phosphorus levels in bones, which can cause rickets.
There is defeciency of vitamin D, calcium or phosphate in the diet. Breastfed child is deficient in these nutrients. Vitamin D is a fat-soluble vitamin that is essential for the normal formation of bones and teeth and absorption of calcium and phosphorus from the bowels. Vitamin D supplementation is recommended to children who are breastfed, especially those who are not exposed to the outdoors or to sunlight. In the vitamin D-dependent and vitamin-D resistant rickets, the child has a genetic defect in which the processing of vitamin D, converting to calcium, and promoting bone growth is impaired. Causes of Rickets /Vitamin D Deficiency
Vitamin D deficiency-Infants and children are at great risk for developing nutritional rickets include dark-skinned infants, exclusively breastfed infants, and infants who are born to mothers who are vitamin D deficient Hypophosphatemic rickets is caused by low levels of phosphate. Renal rickets-Individuals suffering from kidney disease often have decreased ability to regulate the amounts of electrolytes lost in the urine. This includes calcium and phosphate
• Impaired growth
• Increased bone fractures
• Muscle cramps
• Bone pain or tenderness
• dental problems
• muscle weakness
• increased tendency for fractures
• Skeletal deformity (bowed legs, knock knees, cranial, pelvic, spinal deformities)
• Growth disturbance
• Low level of calcium in blood
• Tetany (uncontrolled muscle spasms all over the body)
• Soft skull • Widening of wrist raises early suspicion, it is due to metaphysial cartilage hyperplasia.
• Medical and nutritional history
• X-rays of the affected bones can reveal bone deformities.
• Blood and urine tests
• Physical examination
• Bone biopsy
• Serum alkaline phosphatase
• Urine calcium
• Intake of calcium
• An adequate intake of iron and ascorbic acid
• Light massage twice a week is also beneficial.
• Foods rich in vitamin D include egg yolks, butter, vitamin D-fortified milk, fish liver oil, breast milk, and infant formula.
• Pure vegetarians may use supplements instead of eggs and dairy as sources for both calcium and vitamin D.
• Sun exposure
• Skeltal deformities
• Skeltal fractures
Calcarea fluorica –
Rachitic enlargement of femur in infants Enlargement of bones, with or without caries.
Swelling of bones of jaw after extraction of teeth with violent pains.
Violent bone pains,with swelling.
Weakning in limbs Trembling in hands Cold sweat on legs at night
Arms and hands become numb Patient can lie only on right side Burning in feet with weakness and trembling.
Calcarea phosphorica –
A great remedy for non-union of fractured bones when due to impaired nutrition.
Stiffness and pain with cold , numb feeling Pain in joints and bones
Ruta graveolens –
Especially useful where non-union results, because of deficient callus.
Pain and stiffness in wrists and hands.
Pain in bones of feet and ankles
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