RESEARCH STARTER

Rickets

Rickets is a bone disorder primarily affecting children, characterized by the softening and weakening of bones due to deficiencies in vitamin D, calcium, or phosphate. The condition can lead to a variety of symptoms, including pain in the long bones and pelvis, skeletal deformities such as bowed legs, and other issues like spinal deformities and dental problems. The root causes of rickets often include insufficient dietary intake or absorption of essential nutrients, as well as hereditary factors that may impair the body’s ability to retain phosphate.

Symptoms can range from mild to severe and may manifest as muscle cramps, general weakness, and impaired growth. If untreated, rickets can result in permanent skeletal deformities and hindered growth. Treatment typically involves dietary supplementation of calcium, phosphate, and vitamin D, alongside moderate sunlight exposure. In some cases, physical supports like braces or surgical interventions may be necessary to correct deformities. Understanding rickets is crucial for early detection and effective management to prevent long-term consequences in affected children.

Full Article

DEFINITION: A condition involving the softening and weakening of a child’s bones, primarily caused by lack of vitamin D and/or lack of calcium or phosphate

  • ANATOMY OR SYSTEM AFFECTED: Bones, musculoskeletal system, teeth
  • CAUSES: Vitamin D, calcium, or phosphate deficiency; hereditary factors
  • SYMPTOMS: Pain or tenderness in long bones and pelvis, skeletal abnormalities (bowlegs, bumps in ribcage), spinal and pelvic deformities (scoliosis), odd-shaped skull, increased tendency toward fractures, dental abnormalities, muscle cramps, impaired growth, decreased muscle tone and growth, general weakness
  • DURATION: Short-term to chronic
  • TREATMENTS: Dietary supplements, moderate exposure to sunlight

Causes and Symptoms

Rickets is a relatively rare bone disease that most frequently afflicts children. It is the result of insufficient or inefficient absorption of vitamin D in the body, which causes a progressive softening and weakening of the bone. Certain physical conditions can reduce the digestion or absorption of fats and may also diminish vitamin D absorption by the intestines. The loss of calcium and phosphate from the bone eventually causes destruction of the supportive bone matrix. In adult deficiency, demineralization (osteomalacia) may occur in the spine, pelvis, and lower extremities, causing osteoporosis (an adult condition causing brittle bones).

Symptoms of rickets may include pain or tenderness of the long bones and pelvis, skeletal abnormalities such as bowlegs, bumps in the rib cage (rachitic rosary), spinal and pelvic malformation (including kyphosis or scoliosis), pigeon breast, an asymmetrical or odd-shaped skull, increased tendency toward fractures, dental deformities and cavities, night fevers, muscle cramps, impaired growth, decreased muscle tone and growth, and general weakness and restlessness.

Hereditary rickets, or hypophosphatemic rickets, is a sex-linked vitamin D-resistant disorder that occurs when the kidney is unable to retain phosphate. X-linked hypophosphatemia (XLH) is the most common form of hereditary rickets, caused by a mutation in the PHEX gene. The condition may also occur in children with liver disorders or biliary disorders, when vitamin D and fats are inadequately absorbed.

Treatment and Therapy

Uncomplicated infantile rickets can be cured with a daily replacement of deficient calcium, phosphorous, and vitamin D. Clinical testing reveals improvement after one week. Dietary sources of vitamin D include fish, liver, and processed milk. In addition, moderate exposure to sunlight is therapeutic. Skeletal abnormalities can be corrected with good posture or body braces; in some cases, surgery may be necessary. If rickets is not corrected in children, short stature and skeletal abnormalities may become permanent.


Bibliography

Bentley, George, and Robert B. Greer, editors. Orthopaedics. 4th ed., Buttersworth, 1993.

Currey, John D. Bones: Structures and Mechanics. 2nd ed., Princeton UP, 2006.

Dahash, Basma A., and Senthilkumar Sankararaman. "Rickets." National Institutes of Health, StatPearls, 7 Aug. 2023, www.ncbi.nlm.nih.gov/books/NBK562285. Accessed 19 Aug. 2025.

Gentile, Cristina, and Francesco Chiarelli. "Rickets in Children: An Update." Biomedicine, vol. 9, no. 7, p. 738, 27 June 2021, doi:10.3390/biomedicines9070738. Accessed 18 Aug. 2025.

“Hereditary Hypophosphatemic Rickets.” MedlinePlus, medlineplus.gov/genetics/condition/hereditary-hypophosphatemic-rickets. Accessed 18 Aug. 2025.

Parker, James N., and Phillip M. Parker. Rickets: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. ICON, 2004.

"Rickets." Cleveland Clinic, 5 Aug. 2025, my.clevelandclinic.org/health/diseases/22459-rickets. Accessed 19 Aug. 2025.

"Rickets." MedlinePlus, US National Library of Medicine, 15 July 2024, medlineplus.gov/ency/article/000344.htm. Accessed 19 Aug. 2025.

"Rickets and Osteomalacia." National Health Service, 9 July 2025, www.nhs.uk/conditions/rickets-and-osteomalacia. Accessed 18 Aug. 2025.

Tortora, Gerard J., and Bryan Derrickson. Principles of Anatomy and Physiology. 15th ed., Wiley, 2017.

Wenger, Dennis R., and Mercer Rang. The Art and Practice of Children’s Orthopaedics. Raven, 1993.

Full Article

DEFINITION: A condition involving the softening and weakening of a child’s bones, primarily caused by lack of vitamin D and/or lack of calcium or phosphate

  • ANATOMY OR SYSTEM AFFECTED: Bones, musculoskeletal system, teeth
  • CAUSES: Vitamin D, calcium, or phosphate deficiency; hereditary factors
  • SYMPTOMS: Pain or tenderness in long bones and pelvis, skeletal abnormalities (bowlegs, bumps in ribcage), spinal and pelvic deformities (scoliosis), odd-shaped skull, increased tendency toward fractures, dental abnormalities, muscle cramps, impaired growth, decreased muscle tone and growth, general weakness
  • DURATION: Short-term to chronic
  • TREATMENTS: Dietary supplements, moderate exposure to sunlight

Causes and Symptoms

Rickets is a relatively rare bone disease that most frequently afflicts children. It is the result of insufficient or inefficient absorption of vitamin D in the body, which causes a progressive softening and weakening of the bone. Certain physical conditions can reduce the digestion or absorption of fats and may also diminish vitamin D absorption by the intestines. The loss of calcium and phosphate from the bone eventually causes destruction of the supportive bone matrix. In adult deficiency, demineralization (osteomalacia) may occur in the spine, pelvis, and lower extremities, causing osteoporosis (an adult condition causing brittle bones).

Symptoms of rickets may include pain or tenderness of the long bones and pelvis, skeletal abnormalities such as bowlegs, bumps in the rib cage (rachitic rosary), spinal and pelvic malformation (including kyphosis or scoliosis), pigeon breast, an asymmetrical or odd-shaped skull, increased tendency toward fractures, dental deformities and cavities, night fevers, muscle cramps, impaired growth, decreased muscle tone and growth, and general weakness and restlessness.

Hereditary rickets, or hypophosphatemic rickets, is a sex-linked vitamin D-resistant disorder that occurs when the kidney is unable to retain phosphate. X-linked hypophosphatemia (XLH) is the most common form of hereditary rickets, caused by a mutation in the PHEX gene. The condition may also occur in children with liver disorders or biliary disorders, when vitamin D and fats are inadequately absorbed.

Treatment and Therapy

Uncomplicated infantile rickets can be cured with a daily replacement of deficient calcium, phosphorous, and vitamin D. Clinical testing reveals improvement after one week. Dietary sources of vitamin D include fish, liver, and processed milk. In addition, moderate exposure to sunlight is therapeutic. Skeletal abnormalities can be corrected with good posture or body braces; in some cases, surgery may be necessary. If rickets is not corrected in children, short stature and skeletal abnormalities may become permanent.


Bibliography

Bentley, George, and Robert B. Greer, editors. Orthopaedics. 4th ed., Buttersworth, 1993.

Currey, John D. Bones: Structures and Mechanics. 2nd ed., Princeton UP, 2006.

Dahash, Basma A., and Senthilkumar Sankararaman. "Rickets." National Institutes of Health, StatPearls, 7 Aug. 2023, www.ncbi.nlm.nih.gov/books/NBK562285. Accessed 19 Aug. 2025.

Gentile, Cristina, and Francesco Chiarelli. "Rickets in Children: An Update." Biomedicine, vol. 9, no. 7, p. 738, 27 June 2021, doi:10.3390/biomedicines9070738. Accessed 18 Aug. 2025.

“Hereditary Hypophosphatemic Rickets.” MedlinePlus, medlineplus.gov/genetics/condition/hereditary-hypophosphatemic-rickets. Accessed 18 Aug. 2025.

Parker, James N., and Phillip M. Parker. Rickets: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. ICON, 2004.

"Rickets." Cleveland Clinic, 5 Aug. 2025, my.clevelandclinic.org/health/diseases/22459-rickets. Accessed 19 Aug. 2025.

"Rickets." MedlinePlus, US National Library of Medicine, 15 July 2024, medlineplus.gov/ency/article/000344.htm. Accessed 19 Aug. 2025.

"Rickets and Osteomalacia." National Health Service, 9 July 2025, www.nhs.uk/conditions/rickets-and-osteomalacia. Accessed 18 Aug. 2025.

Tortora, Gerard J., and Bryan Derrickson. Principles of Anatomy and Physiology. 15th ed., Wiley, 2017.

Wenger, Dennis R., and Mercer Rang. The Art and Practice of Children’s Orthopaedics. Raven, 1993.

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