ortho rickets

8/6/2019 Ortho Rickets

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RICKETS


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Rickets is a disorder caused by a lack of vitamin

D, calcium, or phosphate.

It leads to softening and

weakening of the bones.


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Vitamin D helps the body control calcium and

phosphate levels. If these minerals becometoo low, the body may produce hormonesthat cause Ca and P to be released from thebones = weak and soft bones.

Not getting enough calcium and phosphorous(hypophosphatemic rickets) in your diet canalso lead to rickets.

Lack of sunlight.

Age 3months -3years.


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Rickets may occur in children who

have disorders of the liver.

Disorders that reduce the digestion or

absorption of fats will make it more

difficult for vitamin D to be absorbedinto the body.

Drug-induced rickets may occur in

association with the use of the

anticonvulsive drug PHENYTOIN

(interferes with Vit.D metabolism in

the liver)


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Individuals suffering from kidney

disease often have decreasedability to regulate the amounts

of electrolytes lost in the urine.

This includes calcium and

phosphate, and therefore theaffected individuals develop

symptoms almost identical to

severe nutritional rickets.


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A physical exam reveals tenderness or pain inthe bones, rather than in the joints or muscles.

The following tests may help diagnose rickets:

y Bone x-rays

y Bone Biopsy

y Serum Calcium

y Serum Phosphatey Serum alkaline phosphatase

y 24 hour Urine calcium


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Blood Chemistry Increased Decreased

SERUM CALCIUM Vit. D deficiency:

Malabsorption

Dietary deficiency

Anti-convulsant Drug

Ca Deficiency

SERUM

ALKALINE

PHOSPHATASE

Vit. D deficiency

Hypophosphatemic

rickets

24 HOUR

URINARY

CALCIUM

Hypophosphatemic

rickets

Vit. D deficiency

Ca Deficiency


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y Bone pain or tenderness (Arms, Legs,

Pelvis, Spine)

y Dental deformities

y

Delayed formation of teethy Increased cavities in the teeth (dental

caries)

y

Impaired growth

y Softened vertebrae become compressed ,

shortening patients trunk and deforming

thorax (Kyphosis)


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y Weakness and unsteadiness (risk of falls

and fractures)

y Short stature (adults less than 5 feet tall)

Skeletal deformities

Asymmetrical or odd-shaped skullBowlegs

Bumps in the ribcage (rachitic rosary)

Breastbone pushed forward (pigeon chest)

Spine deformities (spine curves

abnormally,

including scoliosis or kyphosis)


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in very severe rickets, patients may

develop even more serious signs and

symptoms associated with very low

levels of calcium or phosphate.

These might include tetany (involuntary

muscle contractions) or seizures.


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The goals of treatment are to relieve symptoms

If rickets is caused by a metabolic problem, a

prescription for vitamin D supplements may be

needed.

Diet rich in Ca.

Prevent the complications of calcium and

phosphate deficiency by correcting anyabnormal levels with supplemental calcium or

phosphate as well as the activated vitamin D

(calcitriol).


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Dietary sources of vitamin D include

fish, liver, and processed milk.

Exposure to moderate amounts of

sunlight is encouraged.

Replacing calcium, phosphorus, or

vitamin D that is lacking will eliminate

most symptoms of rickets.


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Gently handled and turned frequently.

Kept from putting their weight on legs or spinalcolumn.

When lift should never put pressure on bone ofchest.

Diaper is applied loosely.

RELIEVING PAIN: Change positions to decrease discomfort from

immobility

Administer prescribed analgesics

ortho rickets

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