Rickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.


  • Lack of vitamin D or calcium
  • Genetic defect

Hypophosphatemic rickets involves a genetic defect that causes abnormalities in the way the kidneys and bones deal with phosphate.

  • Underlying disease

Rickets occasionally develops in children with rare forms of kidney, liver and gut diseases that affect the absorption and metabolism of vitamins and minerals.

  • Northern latitudes

Children who live in geographical locations where there is less sunshine are at higher risk of rickets.

  • Premature birth
  • Anti-seizure medications
  • Exclusively breastfed.

Symptoms and signs of Rickets

Bone pain or tenderness in

  1. Arms
  2. Legs
  3. Pelvis
  4. Spine

Dental deformities

  1. Delayed formation of teeth
  2. Decreased muscle tone
  3. Defects in the structure of teeth; holes in the enamel
  4. Increased cavities in the teeth
  5. Progressive weakness
  • Impaired growth
  • Increased bone fractures
  • Muscle cramps

Skeletal deformities

  1. Asymmetrical or odd-shaped skull
  2. Bow legs
  3. Rachitic rosary
  4. Pigeon shaped chest
  5. Pelvic deformities
  6. Spine deformities (scoliosis or kyphosis)


  • ALP (alkaline phosphatase) isoenzyme
  • Arterial blood gases
  • Blood tests (serum calcium)
  • Bone biopsy (rare)
  • Bone x-rays
  • Calcium (ionized)
  • PTH
  • Serum alkaline phosphatase
  • Serum phosphorus
  • Urine calcium


  •  In case of dietary deficiency or a lack of sun exposure —
  1. Daily calcium and vitamin D supplements
  2. Eating more calcium-rich food (with caution as high calcium doses can lead to hypercalcaemia)
  • In the case of hypophosphatemic rickets – A combination of phosphate supplements and a special form of vitamin D
  • If there is a kidney disease, patients with rickets may require dialysis.
  • In case of bone deformity – A special brace to position the child’s body appropriately as their bones grow


  • Bone fractures
  • Dental defects
  • Failure to grow
  • Pneumonia
  • Seizures
  • Skeletal deformities



  • Sources of vitamin D 
  1. oily fish
  2. liver
  3. eggs
  4. margarine
  5. breakfast cereals with added vitamin D
  • Sources of calcium 
  1. dairy products( milk, cheese and yoghurt)
  2. green vegetables (broccoli and spinach)
  3. wholemeal bread
  4. dried fruits
  5. beans and pulses, such as lentils


It is a natural Source of Vitamin D.

  • Supplements (Vitamin D and Calcium)

Leave a Comment