Rickets is a result of malnutrition and caused by lack of vitamin D in children. It  usually begins in the age of 3 to 18 months old. Lack of vitamin D softens the bones and if it’s severe, leads to higher softness and decrease of bones, which cause the skeletal bones to weaken and bend. Children in growth ages need enough vitamin D to cover bone’s needs to maintain hard and be able to hold the body shape and stand on base.

Although the common cause of this disease is lack of vitamin D but also calcium or phosphorus deficiency may cause rickets. Rickets also might be a result of too little sun exposure or vitamin D absorption blockages, exclusive breastfeeding without vitamin D supplementation, celiac disease, and certain genetic conditions.

Rickets mostly occurred in early 20th century and it’s rate has dropped down significantly later on.

It seems that rickets is a direct cause of malnutrition in most cases whereas it is most common in Middle East, Africa, and Asia than in United States and Europe though some of these cases exposed to enough sunlight due to sunny weather in these areas, but still enough exposure to sunlight is an important factor for prevention of disease.

Rickets might begin from fetus stages if there isn’t enough vitamin D in mother’s blood or in cases of severe osteomalacia, untreated celiac disease, malabsorption, pre-eclampsia, and premature birth[, as a result, the new born baby will have impaired bone quality and the bones might not be able to recover easily after birth.

Sign and Symptoms:

bone softness, tenderness, bending 

 ankle and elbow deformation

bowed legs

bone fractures

stunted growth

bone pain

large forehead

trouble sleeping

muscle spasm

curved spinal cord

intellectual disability

Diagnosis-Rickets might be diagnosed by:

  • Physical examination
  • Blood tests 
  • A bone density scan may be undertaken.
  • Radiography


 Prevention and Treatment:

  Enough exposure to sunlight and have enough vitamin D can obviously prevent this disease specially in early childhood even in maternal stages before birth. The best medical recommendation is 400 international units (IU) of vitamin D a day for infants and children to prevent this disease. Phosphorus and calcium are essential for vitamin D absorption in body, so enough amount of each is necessary to prevent rickets and have healthy bones.

Treatment had started in early stages after medieval time by cod liver oil.

Treatment involves increasing dietary intake of calcium, phosphates and vitamin D. Exposure to ultraviolet B light (most easily obtained when the sun is highest in the sky), cod liver oil, halibut-liver oil, and viosterol are all sources of vitamin D.

A sufficient amount of ultraviolet B light in sunlight each day and adequate supplies of calcium and phosphorus in the diet can prevent rickets. Darker-skinned people need to be exposed longer to the ultraviolet rays.

Foods that contain vitamin D include butter, eggs, fish liver oils, margarine, fortified milk and juice, portabella and shiitake mushrooms, and oily fishes such as tuna, herring, and salmon.


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