Osteomalacia and rickets

This condition is mostly caused by a lack of vitamin D. It affects bone development and causes soft, weak bones (e.g. deformities).

Overview

This condition is mostly caused by a lack of vitamin D. It affects bone development and causes soft, weak bones (e.g. deformities). The condition is called rickets in children and osteomalacia in adults. Ensuring a sufficient supply of vitamin D (sunlight, diet) is recommended as a preventive measure.

Symptoms

Rickets (from infancy):
  • Elastic bone that can be “pushed in” at the back of the skull
  • Delayed closure of the fontanelles
  • “Rachitic rosary”: prominent knobs of bone at the joints between the ribs and rib cage (looks like a string of pearls)
  • Delay in teeth coming through, defective tooth enamel, cavities
  • Skeletal deformities (most often affecting the leg bones, ribs and spine)
  • Muscle weakness, increased muscle excitability, seizures
Osteomalacia (in adults):
  • Dull bone pain (particularly in the spine, pelvis and upper thighs)
  • Complication: spontaneous bone fractures (i.e. without external trauma)

Causes and treatment

Causes

  • Vitamin D deficiency
    • Reduced UV radiation (sunlight)
    • Reduced intake via food (malnutrition)
    • Reduced intestinal absorption (e.g. bowel diseases)
  • Impaired vitamin D metabolism
  • Vitamin D is required to aid the absorption of minerals such as calcium and phosphate into the bones in order to make the still-soft bones of infants hard and stable (mineralisation). Osteomalacia is the demineralisation and softening of previously fully developed bones.

Further treatment by your doctor / in hospital

Possible tests
  • Physical examination
  • Blood test
  • X-ray
Possible therapies
  • Treatment of the underlying disease
  • Vitamin D deficiency: vitamin D and calcium supplements

What can I do myself?

  • Regularly spend time outside and engage in outdoor physical activities (follow recommendations for sun protection)
  • Balanced and varied diet (according to the Swiss food pyramid)
    • Important sources of vitamin D: oily fish (e.g. salmon, herring, mackerel), liver, butter, full-cream milk, cheese, eggs
  • Vitamin D supplements for all infants and children up to the age of three
  • In winter: ensure vitamin D supply via food and nutritional supplements or vitamin D supplements
  • Persons at risk (mostly people with too little sun exposure and the over 60s): take vitamin D supplements throughout the year

When to see a doctor?

  • Unusually elastic and bendy bones
  • Muscle pain, cramps, twitching
  • Dull bone pain
  • Spontaneous bone fractures
  • Liver, kidney and bowel diseases
  • Known malnutrition

Further information

Swiss Society of Paediatrics (Schweizerische Gesellschaft für Pädiatrie)
www.swiss-paediatrics.org

Synonyms

rickets, osteomalacia, vitamin d deficiency, juvenile osteomalacia, rachitis, bone softening

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