What are the symptoms of rickets?

Jun 11, 2024 Source: Cainiu Health

Dr. Yang Ziqi

Introduction

In general, symptoms of rickets include excessive sweating, cranial softening, rib beading, lower limb deformities, and delayed tooth development. If symptoms of rickets appear, it is recommended to increase sun exposure appropriately and avoid prolonged sitting or standing. At the same time, consuming foods rich in vitamin D, such as animal liver, egg yolks, and milk, can effectively promote recovery from the condition.

Generally, symptoms of rickets include excessive sweating, cranial softening, rib beading, lower limb deformities, delayed tooth development, etc. If discomfort occurs, medical treatment should be sought promptly. Specific analysis is as follows:

1. Occipital alopecia

Patients with rickets sweat more than normal individuals regardless of season. Infants often rub the back of their heads due to irritation from perspiration, leading to hair loss at the枕部 (occipital region), known as occipital alopecia.

2. Cranial softening

This is commonly seen in infants aged 3–6 months and manifests as a large anterior fontanelle and delayed closure, which may not occur until age 2–3 years.

3. Rib beading

Due to abnormal bone development, the junctions between the ribs and costal cartilage may become enlarged like beads, resulting in what is known as "rachitic rosary" or beaded ribs.

4. Lower limb deformities

Because of impaired bone development, the weight-bearing effect may lead to lower limb deformities in patients with rickets, such as bowlegs (O-shaped legs) or knock-knees (X-shaped legs).

5. Delayed dental development

Rickets can cause delayed tooth eruption. In severe cases, teeth may be misaligned and enamel hypoplasia may occur.

If symptoms of rickets appear, it is recommended to moderately increase sun exposure and avoid prolonged sitting or standing. Additionally, consuming foods rich in vitamin D—such as animal liver, egg yolks, and milk—can effectively promote recovery.

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Symptoms of vitamin D-resistant rickets

In the early stage of vitamin D-resistant rickets, children may easily exhibit symptoms such as night terrors, night crying, excessive sweating, and irritability. They may also experience delays in physical development, motor skills, and even brain development. Severely affected children, due to reduced overall immunity, may develop accompanying conditions such as anemia and pneumonia. During the active phase of vitamin D-resistant rickets, children may show obvious skeletal changes.

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What vitamin is deficient in rickets?

Rickets is primarily caused by vitamin D deficiency, and this condition is also known as vitamin D deficiency rickets. Rickets mostly occurs in infants under six months of age. The disease results from insufficient vitamin D in the body, leading to abnormal calcium and phosphorus metabolism, which prevents calcium salts from depositing properly in the bones. Factors contributing to vitamin D deficiency mainly include improper infant feeding, failure to timely supplement cod liver oil, inadequate outdoor activity, and recurrent respiratory infections.

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What is rickets?

In general, rickets is a systemic, chronic, nutritional disorder characterized by skeletal lesions. It is primarily caused by insufficient vitamin D in infants, children, and adolescents, leading to disturbances in calcium and phosphorus metabolism, resulting in a systemic, chronic, nutritional disease featuring skeletal abnormalities. In daily life, it is recommended to increase outdoor activities and sun exposure.

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What element is lacking in rickets?

In general, rickets may be caused by deficiencies in vitamin D, calcium, phosphorus, magnesium, zinc, and other elements. In daily life, it is important to ensure adequate outdoor activities and, whenever possible, go outside to get sunlight exposure during periods of the day when the sun is strong, in order to promote endogenous vitamin D synthesis. Additionally, maintain a balanced diet by consuming more foods rich in calcium, phosphorus, vitamin D, magnesium, zinc, and vitamin K.

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What are the sequelae of rickets?

Sequelae are commonly observed in children over two years of age with severe vitamin D deficiency rickets, which may result in varying degrees of skeletal deformities. Common deformities include pigeon chest, funnel chest, flared ribs, bowlegs (genu varum), and knock-knees (genu valgum). In particularly severe cases, spinal, pelvic, and lower-limb deformities may occur, leading to reduced stature, delayed achievement of sitting, standing, and walking milestones, and abnormal gait.

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Is rickets hereditary?

Rickets is not a hereditary disease; rather, it is a nutritional disorder caused by vitamin D deficiency. Its main manifestations include occipital alopecia, excessive sweating, flared costal margins, and night terrors during infancy. After the child begins walking, bowlegs (O-shaped legs) or knock-knees (X-shaped legs) may develop. These skeletal deformities primarily result from vitamin D deficiency, which impairs calcium absorption.

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Symptoms of Rickets

Rickets symptoms typically include irritability, restlessness, increased nervous system excitability, difficulty falling asleep at night, nocturnal crying, and general agitation. In some cases,枕秃 (occipital alopecia) and excessive sweating may also occur. Around 5 months of age, inadequate vitamin D supplementation may lead to cranial softening (craniotabes). By approximately 8 months of age, it may cause cartilaginous swelling at the wrists and ankles, resulting in wrist and ankle “bracelets.”

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Which department should children with rickets visit?

For rickets in children, pediatric internal medicine is the appropriate specialty to consult. This condition is most commonly seen in infants and young children, particularly those aged 3–18 months. Common causes include prolonged vitamin D deficiency, inadequate nutrition, insufficient ultraviolet (UV) light exposure, rapid growth, liver or biliary disease, insufficient dietary intake of calcium and phosphorus, gastrointestinal disorders, and the effects of certain medications.

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