Rickets

Question 1

What is Rickets?

Answer 1

Normal bony tissue but decreased mineral content. Termed rickets if still growing, Osteomalacia if after epiphysis fusion

Question 2

What are the risk factors for rickets?

Answer 2

Inadequate sunlight exposure
Breast feeding
Family History
Darker skin complexion

Question 3

What causes rickets?

Answer 3

Vitamin D deficiency e.g. malabsorption, lack of sunlight, diet
Renal failure
Drug induced e.g. anticonvulsants
Vitamin D resistant; inherited
Liver disease, e.g. cirrhosis

Question 4

How does rickets present?

Answer 4

Knock-knee
Bow leg
Features of hypocalcaemia

Question 5

How should suspected rickets be investigated?

Answer 5

Bone study:
Vitamin D levels 
Alkaline Phosphate 
Calcium 
Phosphate 
PTH test 

X-ray: children – cupped, ragged metaphyseal surfaces;

Question 6

How is rickets managed?

Answer 6

Treat cause

Calcium with vitamin D tablets