Rickets is a softening of bones in children due to deficiency or impaired metabolism of vitamin D, magnesium,phosphorus or calcium, potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries. The predominant cause is a vitamin D deficiency, but lack of adequate calcium in the diet may also lead to rickets (cases of severe diarrhea and vomiting may be the cause of the deficiency). Although it can occur in adults, the majority of cases occur in children suffering from severe malnutrition, usually resulting from famine or starvation during the early stages of childhood. Osteomalacia is the term used to describe a similar condition occurring in adults, generally due to a deficiency of vitamin D. The origin of the word "rickets" is probably from the Old English dialect word 'wrickken', to twist. The Greek derived word "rachitis" (ραχίτις, meaning "inflammation of the spine") was later adopted as the scientific term for rickets, due chiefly to the words' similarity in sound.

Signs and symptoms of rickets include:

  • Bone pain or tenderness[5]
  • dental problems[5]
  • muscle weakness (rickety myopathy or "floppy baby syndrome" or "slinky baby" (such that the baby is floppy or slinky-like)[6]
  • increased tendency for fractures (easily broken bones), especially greenstick fractures
  • Skeletal deformity[5]
    • Toddlers: Bowed legs (genu varum}[6]
    • Older children: Knock-knees (genu valgum) or "windswept knees"
    • Cranial, pelvic, and spinal deformities (such as lumbar lordosis)
  • Growth disturbance
    Wrist X ray showing changes in rickets, mainly cupping is seen here.
    Chest X ray showing changes consistent with rickets, this changed is usually referred to as Rosary beads of rickets
  • Hypocalcemia (low level of calcium in the blood)
  • Tetany (uncontrolled muscle spasms all over the body)
  • Craniotabes (soft skull)
  • Costochondral swelling (aka "rickety rosary" or "rachitic rosary")
  • Harrison's groove[5]
  • Double malleoli sign due to metaphyseal hyperplasia
  • Widening of wrist[6]raises early suspicion, it is due to metaphysial cartilage hyperplasia.
    Widening of wrist

An X-ray or radiograph of an advanced sufferer from rickets tends to present in a classic way: bow legs (outward curve of long bone of the legs) and a deformed chest. Changes in the skull also occur causing a distinctive "square headed" appearance. These deformities persist into adult life if not treated. Long-term consequences include permanent bends or disfiguration of the long bones, and a curved back.[7]

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