Osteomalacia refers to impaired bone mineralization, caused primarily by deficiencies in vitamin D, calcium, and/or phosphate.
In children, osteomalacia can lead to growth plate abnor...
Inadequate nutrition
Low dietary calcium intake
Strict vegan diet without adequate calcium
Prolonged breastfeeding without vitamin D supplementation
Premature infants taking unfortified f...
Treatment of vitamin D deficiency: high dose repletion with cholecalciferol (vitamin D3) over 8 to 12 weeks ...
Monitor serum calcium, phosphorus, alkaline phosphatase, PTH, and spot urinary calcium/creatinine ratio every 2 to 4 weeks. Note: Alkaline phosp...
Creo AL, Thacher TD, Pettifor JM, et al. Nutritional rickets around the world: an update. Paediatr Int Child Health. 2017;37(2):84–98. [View Abstract on OvidInsights]
Holick MF...
268.0 Rickets, active
268.9 Unspecified vitamin D deficiency
275.40 Unspecified disorder of calcium metabolism
E55.0 Rickets, active
E55.9 Vitamin D deficiency, unspecified
E58 Dietary calci...
Q: What is the best way to diagnose rickets?
A: Laboratory evaluation and radiographs are the best ways to make the diagnosis. Radiographic findings are best seen at the distal radius and ulna, and...
Sign up for a 10-day FREE Trial now and receive full access to all content.
FIGURE 97.4. <bold>A:</bold> Rickets in an 11-month-old boy, breast-fed since birth. Roentgenogram of the upper extremity shows profound demineralization of the skeleton, with frayed, irregular cupping of the end of the metaphysis and poorly defined cortex. Note retardation of skeletal maturation. <bold>B:</bold> Same patient with some healing 4 weeks after supplemental vitamin D. Severe rachitic changes are noticeable. Periosteal cloaking, both of the metacarpals and of the radius and ulna, is evidenc...
FIGURE 97.4. <bold>A:</bold> Rickets in an 11-month-old boy, breast-fed since birth. Roentgenogram of the upper extremity show...
FIGURE 97.5. Rickets in an 11-month-old boy, breast-fed since birth. Roentgenogram of the chest shows demineralization of the skeleton with cupping of the distal end of ribs and humerus.
FIGURE 97.5. Rickets in an 11-month-old boy, breast-fed since birth. Roentgenogram of the chest shows demineralization of the skeleton wit...
FIG. 7.16. Radiographic findings in rickets of the lower extremity. Rachitic changes in the lower extremities of a 2.5-year-old girl with hereditary resistance to vitamin D. A: At presentation, severely deformed epiphyses, demineralization, and bilateral fractures of the femora and tibiae are evident. B: After 4 months of therapy with high-dose calcitrol, dramatic remodeling of the metaphyseal edges has occurred. (From Becker KL, Bilezikian JP, Brenner WJ, et al. Principles and practice of ...
FIG. 7.16. Radiographic findings in rickets of the lower extremity. Rachitic changes in the lower extremities of a 2.5-year-old girl with ...
<bold>Fig B 3-1. Rickets.</bold> (A) Initial film shows severe metaphyseal changes involving the distal femurs and proximal tibias and fibulas. Note the pronounced demineralization of the epiphyseal ossification centers. (B) After vitamin D therapy, there is remineralization of the metaphyses and an almost normal appearance of the epiphyseal ossification centers.
<bold>Fig B 3-1. Rickets.</bold> (A) Initial film shows severe metaphyseal changes involving the distal femurs and proximal ti...
Figure 14-24 <bold>RICKETS: RACHITIC ROSARY. PA Chest.</bold> Observe the opaque, bulbous indentations of the lung adjacent to the enlarged costochondral junctions (<italic>arrows</bold>).
Figure 14-24 <bold>RICKETS: RACHITIC ROSARY. PA Chest.</bold> Observe the opaque, bulbous indentations of the lung adjacent to...
The growth plate in rickets. The growth plate is thickened and disorganized, with a large zone of hypertrophic cartilage cells. There is irregular perforation of the cartilage plate by osteoclasts because there is little calcified cartilage. The woven bone on the surface of some of the primary trabeculae is unmineralized and therefore easily fractured. Such microfractures often lead to hemorrhage at the interface between the plate and the metaphysis.
The growth plate in rickets. The growth plate is thickened and disorganized, with a large zone of hypertrophic cartilage cells. There is i...