Difference between revisions of "Rickets"

(Clinical Features)
Line 10: Line 10:
 
==Clinical Features==
 
==Clinical Features==
 
*Peak incidence between 3 and 18 months of age
 
*Peak incidence between 3 and 18 months of age
*Enlarged skull, joints of long bones, and rib cage
+
*Enlarged and soft skull (Craniotabes)
 +
*Enlarged joints of long bones
 +
*Enlarged joints of the rib cage (aka "rickety rosary"
 +
*Double malleoli sign due to metaphyseal hyperplasia
 +
*Widening of wrist due to metaphyseal cartilage hyperplasia
 
*Curvature of the spine and femurs
 
*Curvature of the spine and femurs
 +
**Bowed legs in toddlers (Genu varum)
 +
**Knock-knees in older children (Genu valgum)
 
*Generalized muscle weakness
 
*Generalized muscle weakness
 +
*Bony pain or tenderness
 +
*Dental problems
 +
*Growth disturbance
 +
*Hypocalcemia
 +
**Tetany
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==

Revision as of 10:43, 13 January 2017

Background

  • Preventable condition in infants and children that is attributed to Vitamin D deficiency and Hypocalcemia
  • Extreme deficiency leading to decrease bone mineralization in children, with or without hypocalcemia
  • Risk factors for Vitamin D deficiency in infants include:
    • Exclusive breastfed infants without vitamin D supplementation
    • Dark skin pigmentation
    • Maternal Vitamin D deficiency
      • In utero, 25-hydroxyvitamin D passes through the placenta to the infant

Clinical Features

  • Peak incidence between 3 and 18 months of age
  • Enlarged and soft skull (Craniotabes)
  • Enlarged joints of long bones
  • Enlarged joints of the rib cage (aka "rickety rosary"
  • Double malleoli sign due to metaphyseal hyperplasia
  • Widening of wrist due to metaphyseal cartilage hyperplasia
  • Curvature of the spine and femurs
    • Bowed legs in toddlers (Genu varum)
    • Knock-knees in older children (Genu valgum)
  • Generalized muscle weakness
  • Bony pain or tenderness
  • Dental problems
  • Growth disturbance
  • Hypocalcemia
    • Tetany

Differential Diagnosis

Evaluation

Management

  • Prevention key:
    • For healthy infants, children, and adolescents recommend a vitamin D intake of at least 400 IU/day

Disposition

See Also

External Links

References