Rickets

Revision as of 10:43, 13 January 2017 by Mackeym2 (talk | contribs) (Clinical Features)

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