Rickets Vitamin D deficiency in kids

  • Facts:
    Defective mineralization of both bone and growth plate cartilage

    Vitamin D deficiency leads to decreased intestinal calcium absorption and hypocalcemia
  • History / PE:
    Craniotabes (ping pong ball sensation over occiput)
    Rachitic rosary (enlargement of costochondral junctions)
    Thickening of wrists and ankles
    Harrison groove (horizontal depression over lower chest)
    Large anterior fontanelle
  • Diagnosis:
    Decreased serum calcifediol levels
    Increased alkaline phosphatase
    Characteristic radiologic changes
  • Treatment:
    Oral vitamin D
    Sunlight exposure
  • See Also:
    Osteomalacia (defective mineralization of bone ONLY)
  • Associated With:
    Low birth weight infants
    Unsupplemented dark skinned patients
    RTA type II
  • Differential Diagnosis:
    X-linked hypophosphatemic rickets (decreased serum phosphate)

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August 3rd 2010