Back كساح الأطفال Arabic Raquitismu AST Raxit Azerbaijani Рахіт Byelorussian Рахит Bulgarian রিকেটস্ Bengali/Bangla Rahitis BS Raquitisme Catalan ئێسکەنەرمە CKB Křivice Czech
| Rickets | |
|---|---|
 | |
| X-ray of a two-year-old with rickets, with a marked bowing of the femurs and decreased bone density | |
| Pronunciation | |
| Specialty | Pediatrics, rheumatology, dietetics |
| Symptoms | Bowed legs, stunted growth, bone pain, large forehead, trouble sleeping[1][2][3] |
| Complications | Bone fractures, muscle spasms, abnormally curved spine, intellectual disability[3] |
| Usual onset | Childhood[3] |
| Causes | Diet without enough vitamin D or calcium, too little sun exposure, exclusive breastfeeding without supplementation, celiac disease, certain genetic conditions[2][3][4] |
| Diagnostic method | Blood tests, X-rays[2] |
| Differential diagnosis | Fanconi syndrome, scurvy, Lowe syndrome, osteomalacia[3] |
| Prevention | Vitamin D supplements for exclusively-breastfed babies[5] |
| Treatment | Vitamin D and calcium[2] |
| Frequency | Relatively common (Middle East, Africa, Asia)[4] |
Rickets, scientific nomenclature: rachitis (from Greek ῥαχίτης,[6] meaning 'in or of the spine'), is a condition that results in weak or soft bones in children, and is caused by either dietary deficiency or genetic causes.[2] Symptoms include bowed legs, stunted growth, bone pain, large forehead, and trouble sleeping.[2][3] Complications may include bone deformities, bone pseudofractures and fractures, muscle spasms, or an abnormally curved spine.[2][3]
The most common cause of rickets is a vitamin D deficiency, although hereditary genetic forms also exist.[2] This can result from eating a diet without enough vitamin D, dark skin, too little sun exposure, exclusive breastfeeding without vitamin D supplementation, celiac disease, and certain genetic conditions.[2][3] Other factors may include not enough calcium or phosphorus.[4][5] The underlying mechanism involves insufficient calcification of the growth plate.[7] Diagnosis is generally based on blood tests finding a low calcium, low phosphorus, and a high alkaline phosphatase together with X-rays.[2]
Prevention for exclusively breastfed babies is vitamin D supplements.[5] Otherwise, treatment depends on the underlying cause.[2] If due to a lack of vitamin D, treatment is usually with vitamin D and calcium.[2] This generally results in improvements within a few weeks.[2] Bone deformities may also improve over time.[5] Occasionally surgery may be performed to correct bone deformities.[8][3] Genetic forms of the disease typically require specialized treatment.[5]
Rickets occurs relatively commonly in the Middle East, Africa, and Asia.[4] It is generally uncommon in the United States and Europe, except among certain minority groups.[3][4] It begins in childhood, typically between the ages of 3 and 18 months old.[3][4] Rates of disease are equal in males and females.[3] Cases of what is believed to have been rickets have been described since the 1st century,[9] and the condition was widespread in the Roman Empire.[10] The disease was common into the 20th century.[9] Early treatments included the use of cod liver oil.[9]
- ^ Elder CJ, Bishop NJ (May 2014). "Rickets". Lancet. 383 (9929): 1665–1676. doi:10.1016/S0140-6736(13)61650-5. PMID 24412049. S2CID 208788707.
- ^ a b c d e f g h i j k l m "Rickets". Genetic and Rare Diseases Information Center (GARD) – an NCATS Program. 2013. Retrieved 19 December 2017.
- ^ a b c d e f g h i j k l "Rickets, Vitamin D Deficiency". NORD (National Organization for Rare Disorders). 2005. Retrieved 19 December 2017.
- ^ a b c d e f Creo AL, Thacher TD, Pettifor JM, Strand MA, Fischer PR (May 2017). "Nutritional rickets around the world: an update". Paediatrics and International Child Health. 37 (2): 84–98. doi:10.1080/20469047.2016.1248170. PMID 27922335. S2CID 6146424.
- ^ a b c d e "Rickets - OrthoInfo - AAOS". September 2010. Retrieved 19 December 2017.
- ^ Cite error: The named reference
:0was invoked but never defined (see the help page). - ^ Florin T, Ludwig S, Aronson PL, Werner HC (2011). Netter's Pediatrics E-Book. Elsevier Health Sciences. p. 430. ISBN 978-1455710645.
- ^ El-Sobky TA, Samir S, Baraka MM, Fayyad TA, Mahran MA, Aly AS, et al. (January 2020). "Growth Modulation for Knee Coronal Plane Deformities in Children With Nutritional Rickets: A Prospective Series With Treatment Algorithm". Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews. 4 (1): e19.00009. doi:10.5435/JAAOSGlobal-D-19-00009. PMC 7028784. PMID 32159063.
- ^ a b c Rajakumar K (August 2003). "Vitamin D, cod-liver oil, sunlight, and rickets: a historical perspective". Pediatrics. 112 (2): e132–e135. doi:10.1542/peds.112.2.e132. PMID 12897318.
- ^ Brown M (19 August 2018). "Evidence in the bones reveals rickets in Roman times". The Guardian. Retrieved 20 August 2018.