Rickets

Morning Report
November 10, 2008
Rochelle Naylor, MD

Physical exam finding

Dietary deficiency
Causes of rickets
Dietary deficiency
Vit D deficient rickets
Inadequate calcium or phosphate intake
Pseudovitamin D deficiency/ Vitamin D- D dependent
rickets
1 alpha hydroxylase deficiency
dep)
Mutations in the gene encoding the vitamin D receptor
X-linked linked hypophosphatemic rickets
Vitamin D resistance (Formerly, Type 2 vit D-dep) D
Hereditary hypophosphatemic rickets with hypercalciuria

Signs and symptoms of rickets
Decreased linear
growth
Muscular hypotonia
Bone pain
Delayed fontanelle
closure
Parietal and frontal
bossing
Craniotabes
Rachitic rosary
Harrison
sulcus/groove
Splayed metaphyses,
wide epiphyses
Bowing of femur and
tibia
Fractures

Radiographic findings of rickets

Radiographic findings of rickets

Vit D resistant
Laboratory findings

Treatment of rickets
Depends on the etiology
Vitamin D deficient rickets
Ergocalciferol 2,000-10,000 2,000 10,000 IU/day
Calcium 1,000 mg/day

Take Home Points
Vitamin D deficiency is the most common
cause of rickets
Vitamin D deficiency is preventable
Screen high-risk high risk patients
Supplement 400 IU/day beginning within the
first few days of life