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Rickets in children: signs, symptoms and treatment, prognosis

What it is?

Disorders of calcium-phosphorus hemostasis in the body of very young children, in most cases, manifest hypocalcemia of various genesis with clinical symptoms of musculoskeletal pathologies. Their most frequent manifestation in children is rickets, vitamin deficiency disease.

This form of hypocalcemia belongs to the group of diseases of metabolic disorders of a polyetiological nature (developing as a result of multiple causal factors) arising from an imbalance of need and insolvency of the provision of metabolic processes and transportation of phosphorus-calcium salts in the body of a child.

The lack of mineralization (osteomalacia) of the bone matrix causes pathological disorders in the bone tissues. Such disorders are manifested by rickets in infants, and in children after a year and in adults - osteoporosis.

The frequency of the disease does not depend on any regional features, however, it is noted to be frequent in places where solar activity is rare.

Subsequently, kids with such a pathology make up the main category in the group of frequently ill children.


Causes of rickets in children

Rickets in children

The leading factors for the development of calcium-phosphorus deficiency in young children are:

  • Prematurity of the infant (premature birth), since it is in the last trimester of pregnancy that the inflow of these minerals to the fetus is most intense.
  • Feeding errors due to calcium-phosphorus deficiency. After all, it was not without reason noted that the cause of rickets in children is a great need for the mineral components of a growing organism.
  • Renal pathology, diseases of the bone and gastrointestinal tract, causing disturbances in the transport of essential minerals.
  • Increased pollution of the body with lead, strontium and chromium, damaging the bone structure.
  • Genetic inheritance in 80% of cases determines the factor of variability (variability) of bone density.
  • Almost all endocrine pathologies contribute to the development of structural disorders of bone tissue (osteopenic conditions).
  • The consequences of deficiency in the body of vitamin D, with rickets, subsequently manifest a negative impact on the ontogenesis (individual development) of babies, impaired immunity functions, provoking the infant form of D-deficient rickets.

Signs and symptoms of rickets in a child according to the forms of the disease

symptoms of rickets in a child

According to the metabolic disruptions in the body, certain signs of rickets in children are formed. What contribute to:

Недостаток кальция вызывает кальцийпеническую форму рахитизма, с характеристикой деформаций костных структур обусловленных процессом остеомаляции. 1) Calcium deficiency causes a calciumpenic form of rickets, with the characteristic deformations of bone structures caused by the osteomalacia process.

Pronounced increased neuromuscular irritation, hyperhidrosis (excessive sweating), disturbances in heart rhythm, sleep and digestive disorders. It is characterized by a rapid course and a rapid decrease in the level of cation (“Ca” ionized) in red blood cells and its serum.

Фосфородефицитная форма проявляется с еще большей выраженностью недостаточности фосфорных соединений в сыворотке и красных клетках крови. 2) The phosphorus deficiency form is manifested with an even greater severity of deficiency of phosphorus compounds in serum and red blood cells.

Manifested by sluggish mobility of babies, their motor inhibition, muscular hypotonia, dystrophic changes of the skeletal bones caused by the rapid growth of osteoid tissue (osteoid hyperplasia)

Патология с легкой фосфорно-кальциевой недостаточностью проявляется легким течением с небольшими костными деформациями, незначительными или полностью отсутствующими признаками нервно-мышечных нарушений. 3) Pathology with mild calcium-phosphorus deficiency is manifested by a mild course with minor bone deformities, minor or completely absent signs of neuromuscular disorders.

By the nature of the clinical symptoms in children, rickets can occur:

  1. Acutely, with predominant destruction (discharge) of bone structures;
  2. In subacute form - with the growth of bone growths over the zones of destruction;
  3. Relapsing form - with the manifestation of active "destructive" processes and previously transferred avitaminosis.

The common symptoms of rickets in a child include:

  • microsomia (growth retardation);
  • osteomalacia bones of the parietal region (craniotabes);
  • signs of an elongated skull (dolichophalus);
  • deformation of the ribs in the form of "bird's breast";
  • transverse groove in the deformed chest;
  • kyphosis spine;
  • varus and valgus curvature of the limbs;
  • "Beads on the ribs" (bone growths);
  • thickening on the long bones "in the form of bracelets";
  • formation of seals on the phalanges in the form of pearl threads "

Symptoms of rickets in infants

Symptoms of rickets in infants

Signs of rickets in infants are manifested according to the stage of the disease caused by gradual development.

Symptoms of the initial period of rickets manifest in infants of 3, 4 months of age. Sometimes this happens in two-month-old babies or in half a year old babies.

There is a pattern of manifestation of pathology in conjunction with infectious and catarrhal diseases, the rapid weight gain of the child can also be the impetus for development. The duration of the debut period is about a month.

At this time, manifestations associated with abnormalities in the autonomic and central nervous system are characteristic, manifesting themselves:

  • Increased sweating in the baby during normal play movements and breastfeeding;
  • Baldness of the occipital region of the head - a consequence of friction of the head in response to irritation afterwards;
  • Fearfulness and shuddering, at the slightest noise;
  • Irritability;
  • Manifestation of red stripes over the skin (signs of red dermographism).

Muscular disorders in infants with rickets show weakness and lethargy of the muscles, recurrent constipation. The lesion of the skeletal system is manifested by a small compliance in the bony edges of the fontanelic and sternal costal region. In the tubular long bones, the formation process is inhibited.

The period of the height of the disease is characterized by pathologies of muscle and bone structures, disturbances in metabolic processes. It is at this time that rickets can manifest itself in varying degrees of severity.

  • The development of osteomalacia is characteristic (the mineralization of the cartilage and bone tissues is disturbed), which subsequently passes into osteoporosis ;
  • Observed tuberosity of the parietal zone;
  • The development of exostosis (cartilaginous growths) in the junction zones of the sternum with the clavicle, the wrist and the ankle in the form of "monastic rosary";
  • Bone deformity of the sternum, as a result of the rapid formation of ribs;
  • Coastal retraction in the zone of the extended lower cartilaginous aperture of the sternum.

In the severe form of the disease marked the formation of indentation or excessive chest swelling. In a child, the bones of the clavicle are bent, and a varus or valgus curvature of the legs appears. Stomach spreads out. The shape of the head becomes angular with a bulging, abnormally prominent forehead. The processes of curvature of the sky and jaw are noted. Teething is very late.

Very often, babies refuse breastfeeding or formula, as sucking reflexes are lost. Does not help and reduce the frequency of feeding.

violation of the formation of bones with rickets, photo

violation of the formation of bones with rickets, photo

Anemic hypoxia and a decrease in enzymatic synthesis increase. Characterized by lethargy, drowsiness and pallor of the child. Motor functions are impaired, the kids are not able to roll over, sit down and especially walk. Immunity decreases, increasing the risk of developing acute pathological processes.

The stage of residual manifestations is caused by skeletal deformity, microsomia and fermentopathies, underdevelopment of muscles and a deficit of psychomotor functions. Gradually, general well-being improves significantly, neurological symptoms and autonomic disorders pass. The curvature of the limbs smoothes over time.

But, if psychosomatic pathology can be treated, then dentofacial defects and skeletal deformity will remain forever.

What threatens the neglect of the disease?

The delay in the treatment of rickets and neglect of the process can cause catastrophic consequences, leading to:

  • to the curvature of the spine and the formation on it of bone growth in the form of a hump;
  • constriction of the pelvic bones, leading to joint hip dysplasia;
  • flatfoot and curvature of the legs;
  • asymmetric head shape;
  • education on the skeletal bones of cartilaginous growths and bumps;
  • enlarged liver and spleen;
  • articular looseness.

To prevent the disability of babies can only timely treatment.

Methods of treatment of rickets in children - drugs and nutrition

treatment of rickets in children

At the first symptoms of rickets in children and in treatment and prevention, rational nutrition is important. Since it is with food kids get the necessary macro and microelements for growth and development. It is necessary to consider some features:

  1. In the treatment of rickets in a child complementary food is introduced earlier in the month and a half than healthy kids. It must be carefully frayed. From five months you can include chicken yolk, liver of a rabbit, make soufflés of kidneys, meat and brain. Fruit puree does not abuse.
  2. Porridges are prepared on vegetable broths and given once a day.
  3. Vegetable puree from zucchini, carrots, cabbage and green peas are useful.
  4. Fruit purees - from apples, carrot and pumpkin are introduced gradually starting from half a teaspoon, bringing to 6/25 by 100 months. per day in four doses.
  5. Infants who are on artificial or mixed feeding with a pronounced sympathy of rickets in the diet add from 10 to 15 drops of lemon juice. “C” vitamin rickety children is necessary for better absorption of potassium-phosphorus elements by the stomach and for regulating the functions of the parathyroid gland.
  6. It is necessary to be careful with fats, their surplus complicates the process of assimilation of mineral salts.

Observing the condition of patients with rickets of children, if necessary, water or oil solutions of vitamin “D” containing preparations - “Akvadetrim”, “Devisol”, “Vigantol”, “Videoin”, or “Ergocalciferol” can be prescribed by a doctor. Dosage and course are individual.

When severe symptoms of rickets, drugs are added to the treatment - “Potassium Orotate”, “Carnitine”, “ATP”, restoring metabolic processes.

Corrective and relaxing massage techniques, exercise therapy exercises, conifers and salt baths are used as rehabilitation therapy.

With a clear curvature of the legs in older children (1.5-2 years), a fixing splint is used on the lower leg and thigh with a redressing corsage on the knee joints. Redress applies up to the age of three. Full load on the legs is limited to 5 years and is allowed only after a medical course of treatment until bone calcification.

In parallel, courses of massage that stimulate the muscles of the buttocks, legs and back are prescribed. Conduct manual correction of the joints. Wearing orthopedic shoes is recommended for unloading the legs and to prevent the development of deformity of the feet.

Sometimes an operation in the form of one-sided epiphysiodesis is necessary - fixation of the axis of the limb with brackets and plates. With a large deformity of the leg and thigh, the operation is carried out at the end of the growth of the child.

What is disease prevention?

Prevention begins long before the birth of the child, in the antenatal period of pregnancy with the proper nutrition of the future mom - taking all prescribed drugs, to improve the phosphorus-potassium metabolism of the fetus, sufficient stay in the sun. All these measures will reduce the risk of rickets.

In the postnatal period, feeding the baby with breast milk is of great importance. When transferring to a mixture, you need to choose the food as close as possible to breast milk.

Babies need regular massage, gymnastic exercises and long walks with a stay in the sun in the morning when the sun's rays are not aggressive. Children at risk are prescribed vitamin D preparations.


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