Osteomalacia (pronounced ), known as rickets in children, where the epiphyseal growth plates are yet to seal (taken from the Greek word (rhákis), meaning "spine"), is a disorder most commonly caused by vitamin D deficiency. This results in insufficient calcium uptake by bones in developing children. It can also arise, however, from other etiologies such as rare mesenchymal tumors or any phosphate-wasting disease. Because calcium is an essential nutrient which aids in bone rigidity, the lack of it being absorbed into the body causes fragile or malformed bones, which are unable to support the weight of a growing body. Calcium or phosphorus deficiency in children is termed rickets, while that of adults is termed osteomalacia.

Although osteomalacia can occur in adults, the majority of cases occur in children with poor nutrient intake usually resulting from famine or starvation during early stages of childhood.

Manifestations of disease

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Rickets causes bone pain, slowed growth in children, dental problems, muscle loss and increased risk of fractures (easily broken bones). Medical problems seen in children with rickets are

1. Skeletal deformity,
2. Growth disturbance,
3. Hypocalcaemia (low level of calcium in the blood), and
4. Tetany (uncontrolled muscle spasms all over the body).

The X-ray, or radiograph, in the article is the classic image of advanced rickets sufferers: bow legs (outward curve of long bone of the legs) and a deformed chest. Changes in the skull also occur causing a distinctive "square headed" appearance. These deformities persist into adult life.

Treatment and prevention

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Treatment involves increasing dietary intake of calcium, phosphates and vitamin D. Exposure to sunshine, cod liver oil, halibut-liver oil, and viosterol are all sources of vitamin D.

Rickets is a severe and prolonged vitamin D deficiency that leads to softening and weakening of the bones in children. Vitamin D helps the body absorb calcium and phosphate, which children need to build strong bones. Good sources of dietary vitamin D are vitamin D-fortified formulas and milk.

Recommendations are for 200 international units (IU) of vitamin D a day for infants and children. Children who do not get adequate amounts of vitamin D are at increased risk of rickets.

According to the American Academy of Pediatrics (AAP), infants who are breast-fed may not get enough vitamin D from breast milk alone. For this reason, the AAP recommends that infants who are exclusively breast-fed receive daily supplements of vitamin D from age 2 months until they start drinking at least 17 ounces of vitamin D-fortified milk or formula a day.

In addition to inadequate vitamin D in the diet, other causes of rickets include:

• Hereditary rickets (X-linked hypophosphatemia), an inherited form of the disease caused by the inability of the kidneys to retain phosphate;
• Lack of exposure to sunlight, which stimulates the body to make vitamin D;
• Conditions that impair absorption of vitamin D, such as celiac disease or short bowel syndrome.

Signs and symptoms of rickets include:

• Bowed legs
• Leg fractures
• Impaired growth

A doctor may diagnose rickets by:

• Blood tests to measure calcium and phosphorus levels
• X-rays of affected bones

A sufficient amount of sunlight each day and adequate supplies of calcium and phosphorus in the diet can prevent rickets. Darker-skinned babies need to be exposed longer to the ultraviolet rays. The replacement of vitamin D may correct rickets using these methods of ultraviolet light and medicine.

Sufficient vitamin D levels can also be achieved through dietary supplementation. Vitamin D3 (cholecalciferol) is the preferred form since it is more readily absorbed than vitamin D2. Most dermatologists recommend vitamin D supplementation as an alternative to unprotected ultraviolet exposure due to the increased risk of skin cancer associated with sun exposure.

External links

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• Dr. Susan Ott's website on osteomalacia
• Dictionary.com - Osteomalacia
• Fluoride & Osteomalacia
• History of Vitamin D and the battle against Rickets

Pediatrics | Skeletal disorders | Malnutrition

لين عظام | Рахит | Rachitis | Raquitismo | Rakito | Rachitisme | 구루병 | Rachitismo | רככת | Rachitis | くる病 | Rakitt | Krzywica | Raquitismo | Рахит | Rickets | Riisitauti | Rakitis