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    Rickets is a pediatric bone disease caused by vitamin D deficiency and characterized by soft and weak bones. Symptoms include bone pain, dental problems, muscle weakness, and skeletal deformities. Diagnosis involves examining physical signs, biochemical tests showing low calcium and vitamin D, and x-rays showing bone changes. Treatment involves vitamin D and calcium supplementation with follow up to monitor the child's progress.

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    Rickets is a pediatric bone disease caused by vitamin D deficiency and characterized by soft and weak bones. Symptoms include bone pain, dental problems, muscle weakness, and skeletal deformities. Diagnosis involves examining physical signs, biochemical tests showing low calcium and vitamin D, and x-rays showing bone changes. Treatment involves vitamin D and calcium supplementation with follow up to monitor the child's progress.

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    Rickets is a pediatric bone disease caused by vitamin D deficiency and characterized by soft and weak bones. Symptoms include bone pain, dental problems, muscle weakness, and skeletal deformities. Diagnosis involves examining physical signs, biochemical tests showing low calcium and vitamin D, and x-rays showing bone changes. Treatment involves vitamin D and calcium supplementation with follow up to monitor the child's progress.

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    9 views3 pages

    New Microsoft Word Document

    Uploaded by

    meedoasadel
    Rickets is a pediatric bone disease caused by vitamin D deficiency and characterized by soft and weak bones. Symptoms include bone pain, dental problems, muscle weakness, and skeletal deformities. Diagnosis involves examining physical signs, biochemical tests showing low calcium and vitamin D, and x-rays showing bone changes. Treatment involves vitamin D and calcium supplementation with follow up to monitor the child's progress.

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    ‫إعداد الطالب ‪ :‬عبدالحميد محمد إبراهيم سيد أبوطالب‬

    ‫رقم الجلوس ‪22225 :‬‬


    ‫الفرقة ‪ :‬الثانية‬
    Rickets is a pediatric disorder characterized by the softening and weakening of bones in children,
    primarily due to prolonged and severe vitamin D deficiency. Other causes can include calcium or
    phosphate deficiency, and certain metabolic disorders. Here's a detailed review of the diagnosis
    of Rickets:

    1. Clinical Presentation
    Children with rickets may present with several signs and symptoms:

     Bone pain or tenderness


     Dental problems: Delayed tooth formation, defects in the tooth structure, increased
    cavities.
     Muscle weakness
     Skeletal deformities: Such as bowed legs or knock knees, thickened wrists and ankles,
    and chest deformities.
     Growth disturbances: Such as decreased growth velocity and short stature.
     Hypocalcemic symptoms: Such as tetany or seizures in severe cases.

    2. Physical Examination
    During physical examination, specific signs associated with rickets may be observed:

     Rachitic rosary: Swelling of the costochondral joints resembling beads.


     Craniotabes: Softening of the skull bones.
     Harrison’s groove: Indentation along the lower ribs caused by the diaphragm pulling on
    weakened bones.
     Leg deformities: Such as bowing of the legs.

    3. Biochemical Tests
    These tests are crucial in diagnosing and assessing the severity of rickets:

     Serum calcium: Often low in rickets.


     Serum phosphate: Usually decreased due to renal phosphate wasting.
     Alkaline phosphatase: Elevated as a marker of increased bone turnover.
     Parathyroid hormone (PTH): Typically elevated as a compensatory response to
    hypocalcemia.
     25-Hydroxyvitamin D levels: To assess vitamin D status; levels are typically low in
    vitamin D deficiency rickets.

    4. Radiographic Findings
    X-rays are critical in confirming a diagnosis of rickets and assessing the severity of bone
    changes:
     Widening, fraying, and cupping of the metaphyses of the long bones, particularly
    around the wrists, knees, and ankles.
     Generalized osteopenia: Low bone density visible on X-rays.
     Delayed bone age.

    5. Differential Diagnosis
    It’s important to differentiate rickets from other conditions that can cause similar symptoms,
    such as:

     Osteomalacia: The adult equivalent of rickets, where bone softening occurs after the
    growth plates have closed.
     Genetic disorders: Such as hypophosphatemic rickets or disorders of vitamin D
    metabolism.
     Nutritional deficiencies: Apart from vitamin D, deficiencies in calcium or phosphate.
     Bone diseases: Such as osteogenesis imperfecta or other metabolic bone diseases.

    6. Special Tests
    Depending on the suspected underlying cause, special tests may be required:

     Genetic testing: For familial forms of rickets.


     Urine tests: To evaluate renal phosphate excretion.

    7. Management and Follow-Up


    Following diagnosis, the treatment typically involves supplementation of vitamin D and calcium,
    dietary modifications, and in some cases, orthopedic interventions for skeletal deformities.
    Regular follow-up is essential to monitor the response to treatment and adjust as necessary.

    A comprehensive approach to diagnosis, incorporating clinical, biochemical, radiographic, and


    possibly genetic investigations, is key to appropriately manage and treat rickets, preventing its
    complications and improving outcomes for affected children.
    _______________________________

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