What is rickets?
Rickets is a disease caused by deficiency of Vitamin D leading to bony deformities and hypocalcemia.
What is the first change to appear in Rickets & which is the first finding of healing Rickets?
The first changes of rickets appear in rapidly growing distal ends of ulna & radius (wrist & knee are commonly involved due to more use). Rarefaction of provisional zone of calcification with widening of epiphysis- diaphysis distance is first to appear. Following treatment there is ossification of provisional zone of calcification.
However, early signs of Rickets should be always looked for e.g. On chest X-ray, humoral head may show certain early radiological changes
What is neonatal Rickets?
In first 2 years of life, incidence of Rickets is 5 to 20%. Neonatal rickets is believed to be of multifactorial origin. Major contributing factors are related to nutrition, immaturity of enzyme systems & iatrogenic / metabolic factors. Premature infants of low birth weight are primarily affected. Bony changes appear around 2 months of age. The most frequent causes of Rickets in patients under 6 months of age also include conditions like Biliary Atresia.
What are the sequelae post-rickets?
Complete healing & restoration of normal structure are rule in rickets, however distortion/ sclerosis of spongiosa in affected segment may occur after healing & may remain visible for several years. Cortical thickening of segments of bone involved during active stage also may persist. Angulation deformities secondary to pathological fractures result in deformities like knock-knee, bow leg and sabershin.
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