Rickets is a bone growth disorder in children caused by a lack of vitamin D. Rickets can cause bones to become soft and brittle, making them break easily.
Vitamin D helps to absorb calcium and phosphate from food. Calcium and phosphate are minerals that are important for maintaining bone strength. If the body lacks vitamin D, calcium and phosphate levels in the bones will decrease. As a result, the bones will soften and become brittle.
Rickets usually occurs in children aged 6 months to 3 years. Although it generally occurs in children, this bone disorder can also be experienced by adults. Rickets in adults is also known as osteomalacia or soft bone disease.
Symptoms of Rickets
Rickets causes a child's bones to become brittle, thereby triggering abnormal bone growth. Signs and symptoms that can appear when a child has rickets include:
- Pain in the spine, leg bones, and pelvis.
- Bone abnormalities, such as bent legs, X legs, O legs, or scoliosis.
- Short body, due to stunted growth in height.
- It is easy to break bones due to brittle bones.
- Dental abnormalities, such as slower tooth growth and easy cavities.
In some cases, children with rickets also lack calcium levels in the blood (hypokalemia). This condition makes rickets symptoms worse and causes muscle cramps and tingling in the legs.
When to go to the doctor
Immediately consult a doctor if your child shows symptoms of rickets. If not treated immediately, your child's growth can be disrupted. In addition, the deformity of the bones will be permanent.
Kidney disease can affect the body's absorption of vitamin D. If you suffer from kidney disease, check with your doctor regularly to monitor calcium and phosphate levels in the body.
Consultation with a doctor is also necessary if you have a family history of hereditary diseases that can cause rickets, for example: cystic fibrosis. Examination by a doctor is needed to determine the risk of developing rickets in children later.
Causes of Rickets
Rickets occurs when the body doesn't get enough vitamin D or the body doesn't process vitamin D normally. Vitamin D is needed by the body to help absorb calcium and phosphate from food. Vitamin D deficiency will cause impaired absorption of calcium and phosphate.
Vitamin D deficiency can occur due to lack of skin exposure to sunlight, lack of intake of foods rich in vitamin D, such as fish oil and egg yolks, and impaired absorption of vitamin D. Impaired absorption of vitamin D can be caused by a number of conditions:
- Cystic fibrosis
- celiac disease
- Kidney illness
- Inflammation of the intestine
In rare cases, rickets can also be caused by genetic factors. This type of rickets, called hypophosphatemic rickets, is caused by a kidney disorder in absorbing phosphate.
Rickets Risk Factors
Babies born to mothers who were deficient in vitamin D during pregnancy are more at risk of developing rickets. In addition, rickets is also more at risk in children who have the following conditions:
- Dark skin
- Born prematurely
- Not getting exclusive breastfeeding.
- Live in an area that lacks sunlight.
- Exposure to drugs, such as anticonvulsant and antiviral drugs.
Rickets Diagnosis
To determine whether a child has rickets, the doctor will ask questions about the complaints and symptoms experienced by the child. Next, the doctor will perform a physical examination. One of the tests that can be done is to apply gentle pressure to the child's bones, especially the skull, ribs, and bones in the feet and wrists.
If the child feels pain when the bone is pressed or the doctor suspects that there is an abnormality in the bone, the doctor will perform a follow-up examination in the form of:
- Blood tests, to measure calcium and phosphate levels.
- X-ray or CT scan of the bone, to see if there are any bone deformities.
- Taking a sample of tissue from the bone (biopsy), to be studied in the laboratory.
Rickets Treatment
Treatment of rickets aims to increase the amount of vitamin D in the child's body and relieve symptoms. The trick is to:
- Drying children in the sun regularly.
- Give children foods rich in calcium and vitamin D, such as fish and eggs.
- Provide calcium and vitamin D supplements, if intake from food is lacking.
- Inject vitamin D every year, if the child cannot take supplements, has liver disease, or intestinal disease.
Keep in mind, each child's vitamin D needs can be different. Therefore, the provision of supplements must be adjusted to the daily needs of each child and must not exceed the maximum limit of vitamin intake so that there is no overdose.
If rickets causes bone abnormalities, the doctor will recommend the use of a brace to support the child's bone growth. If the bone deformity is severe, the doctor will perform surgery to repair the child's bones.
Rickets Complications
If left untreated, rickets can cause complications such as:
- Seizures
- Growth disorders
- Dental abnormalities
- Bone pain
- Bone disorders
- Osteoporosis
- Broken bones for no reason
- Spinal curvature abnormalities
Rickets Prevention
Rickets can be prevented by meeting the needs of vitamin D and calcium. Some of the ways this can be done are:
- Bask in the sun for 10-15 minutes a day. Before sunbathing, use sunscreen cream so that the skin does not get sunburned and avoid the risk of skin cancer.
- Eat foods rich in vitamin D, such as egg yolks, tuna or salmon, fish oil, bread, and milk.
- Take vitamin D supplements as recommended by your doctor and regularly check with your doctor, if you are pregnant.