msk - rickets

Question 1

what is rickets

Answer 1

condition affecting children where there is defective bone mineralisation causing “soft” and deformed bones.

Question 2

what doe rickets lead to in adults

Answer 2

osteomalacia.

Question 3

what causes rickets

Answer 3

a deficiency in vitamin D or calcium

Question 4

what is hereditary hypophosphataemic rickets

Answer 4

rare form of rickets
caused by genetic defects that result in low phosphate in the blood.
x linked dominant

Question 5

do rickets px have to have sx

Answer 5

no

Question 6

potential sx of rickets

Answer 6

Lethargy
Bone pain
Swollen wrists
Bone deformity
Poor growth
Dental problems
Muscle weakness
Pathological or abnormal fractures

Question 7

bone deformities in rickets

Answer 7

1. Bowing of the legs
2. Knock knees,
3. Rachitic rosary
4. Craniotabes
5. Delayed teeth with under-development of the enamel

Question 8

what is bowing of the legs in rickets

Answer 8

where the legs curve outwards

Question 9

what are knock knees in rickets

Answer 9

where the legs curve inwards

Question 10

what is Rachitic rosary in rickets

Answer 10

where the ends of the ribs expand at the costochondral
junctions, causing lumps along the chest

Question 11

what are craniotabes in rickets

Answer 11

a soft skull, with delayed closure of the sutures and frontal bossing

Question 12

RF for rickets

Answer 12

same as RF for vit D deficiency

• darker skin
• low exposure to sunlight
• live in colder climates

Question 13

first line lab test for rickets

Answer 13

Serum 25-hydroxyvitamin D

less than 25 nmol/L establishes a diagnosis vitamin D deficiency, which can lead to rickets.

Question 14

diagnostoc test for rickets

Answer 14

x ray

may also show osteopenia (more radiolucent bones

Question 15

what do other labs show for rickets

Answer 15

Serum calcium may be low
Serum phosphate may be low
Serum alkaline phosphatase may be high
Parathyroid hormone may be high

Question 16

what tests can be done to look for other pathology in rickets

Answer 16

FBC & ferritin
ESR&CCRP
kidney function tests
LFT
TFT
anti-TTG antibodies,
autoimmune and rhuematoid tests

Question 17

how to best manage rickets

Answer 17

prevention
Breastfeeding women and all children should take a vitamin D supplement.

Question 18

what dose vitamin d should children take to prevent rickets

Answer 18

400 IU (10 micrograms) per day

Question 19

are breastfed babies or forumla babies at higher rick of rickets

Answer 19

. Breastfed babies are at higher risk of vitamin D deficiency compared with formula fed babies, as formula feed is fortified with vitamin D.

Question 20

how to treat the vit d deficiency

Answer 20

with vitamin D (ergocalciferol).

Question 21

what supplements to take once u have rickets

Answer 21

Vitamin D and calcium supplementatio