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Rickets is a condition that softens, distorts and weakens bones in children. As late as the 1940s rickets was a very common childhood ailment.
A lack of vitamin D or calcium is the most common cause of rickets in children. Among the genetic rickets causes – those that cannot be fixed simply by changing diet and nutrition – the most common is X-linked hypophosphatemic rickets, which happens in 1 out of 20,000 newborns (0.01%). Other genetic causes are very rare.
Children with rickets may suffer from bone pain, bones that break easily, stunted growth, muscle cramps and bone deformities such as bow-leggedness (genu varum), and spinal deformities.
Blood tests can diagnose rickets disease and an X-ray may be needed to understand the extent of bone deformities. Bone density scans may be needed to see how severe the disease is.
In case of deficiencies, the first line of rickets treatment is to add vitamin D and calcium to the diet, to let the body fix any bone problems itself. However, rickets disease caused by a genetic condition may need additional medicines and surgery. In less-severe cases, a brace can be used on the spine or limbs to support the bones as they grow.
In more severe cases of limb deformity, gradual osteotomy (the surgical cutting or removal of a piece of bone to change how bones line up) and the use of an external fixation device can be used to both support and reshape the limbs as they grow and get stronger. Guided growth with small plates can be used to correct deformities.
If untreated, rickets can lead to very stunted growth, dental problems and seizures. Bone problems need to be treated to prevent pain and issues with mobility.