Rickets
Rickets occurs when growing bone does not mineralise normally. Vitamin D or calcium deficiency is common, but phosphate loss, kidney disease and inherited disorders can produce a similar bone pattern.
Key takeaways
- Delayed growth, bowed legs, widened wrists or ankles, muscle weakness and bone pain can suggest rickets in a child.
- Calcium, phosphate, alkaline phosphatase, parathyroid hormone, vitamin D and kidney tests help identify the cause; imaging may support diagnosis.
- Ordinary vitamin D, active vitamin D and phosphate treatment are not interchangeable and can cause harm when used for the wrong mechanism.
Catalogue matches do not establish the cause of rickets or define a safe replacement plan.
Why does the cause change treatment?
Nutritional deficiency reduces the minerals available to harden bone. Kidney and inherited conditions may instead impair vitamin activation or waste phosphate. Growth stage, diet, absorption, medicines and family history provide useful clues.
When is active vitamin D used?
Alfacalcidol has selected roles when vitamin D activation is impaired; it is not routine treatment for every child with rickets. Calcium and phosphate must be monitored because excess treatment can damage kidneys or other tissues. See bone health.
When to seek urgent care
Seek urgent care for seizure, breathing difficulty, severe muscle spasm, confusion, a suspected fracture or a child who cannot stand or bear weight as expected.