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Rickets/Osteomalacia, Pediatric

Alison Boyce, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • 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...

DIAGNOSIS

HISTORY

  • Inadequate nutrition

    • Low dietary calcium intake

    • Strict vegan diet without adequate calcium

    • Prolonged breastfeeding without vitamin D supplementation

    • Premature infants taking unfortified f...

TREATMENT

GENERAL MEASURES

Treatment depends on the underlying etiology. 

ADDITIONAL THERAPIES

  • Treatment of vitamin D deficiency: high dose repletion with cholecalciferol (vitamin D3) over 8 to 12 weeks ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Monitor serum calcium, phosphorus, alkaline phosphatase, PTH, and spot urinary calcium/creatinine ratio every 2 to 4 weeks. Note: Alkaline phosp...

ADDITIONAL READING

  • 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...

CODES

ICD9

  • 268.0 Rickets, active

  • 268.9 Unspecified vitamin D deficiency

  • 275.40 Unspecified disorder of calcium metabolism

ICD10

  • E55.0 Rickets, active

  • E55.9 Vitamin D deficiency, unspecified

  • E58 Dietary calci...

FAQ

  • 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...

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