The calcium and phosphate level in the body is controlled by vitamin D. If the levels fall below a certain level in the blood stream, the body reacts by taking calcium and phosphorus from the bones to maintain the blood stream levels as a result the bones become weak and soft.
Lack of exposure to sunlight (people living in places where there is less exposure to sunlight, people working indoor during sunlight and people those they should live indoors) are at an increased risk of rickets.
Also vegetarianism, no intake of milk, infants only breastfed, family history of rickets and lactose intolerance are the risk factors for rickets. People having digestion and absorption disorders, renal problems and children with certain liver diseases can also suffer from rickets.
Symptoms of rickets are muscle cramps; pain and tenderness of bones of legs, arms, spine and pelvis; growth impairment; increased bone fractures; progressive weakness; hypocalcemia; growth retardation; soft skull; dental deformities; defects in structure of teeth; holes in enamel; late formation of teeth; dental carries; decreased muscle tone; short stature and skeletal abnormalities like bowlegs, odd shaped or asymmetrical skull, pelvic and spine deformities, breastbone pushed forward and bumps in the ribcage.
Pain and tenderness in the bone is the characteristic sign of rickets. Rickets can be diagnosed by medical history, physical examination and few tests. The tests done to diagnose rickets are serum calcium, serum phosphorus, serum alkaline phosphatase, arterial blood gases, bone X-ray and bone biopsy. Other tests are urine calcium, alkaline phosphatase isoenzyme, PTH and ionized calcium.
Treatment is aimed at symptomatic relief and to treat the cause. Restoration of the calcium, phosphorus and vitamin D concentrations cures the symptoms. It may be provided as supplements or diet containing more of these minerals. The dietary sources for vitamin D are fish, processed milk, orange juice, cereals, margarine, eggs, butter, oily fishes and liver. Exposure to sunlight also helps. Surgery may be done to correct the skeletal deformities. To reduce or prevent deformities braces or positioning may be used.
The disorder is cured by supplements of vitamin D and minerals. Deformities should be corrected in childhood so that they improve and disappear over a period of time, otherwise they are permanent.
Diet rich in vitamin D and minerals, diet supplements for these in patients of digestive and absorption disorders, treatment for renal disorders causing the condition and counseling for people having family history of the condition can prevent rickets.
