Rickets | Types of Osteomalacia & Treatment | Nutrition


What is rickets?

Rickets is a skeletal illness caused by a lack of vitamin D, calcium, or phosphate. These nutrients are important for the expansion of strong and healthy bones. Persons with rickets may have weak and soft bones, stunted growth, and in severe cases, skeletal malformations.

Vitamin D helps your body absorb calcium and phosphate from the gut. You can get vitamin D from various food products, such as milk, eggs, and fish. Your body also makes the vitamin when it is exposed to sunlight.

A vitamin D deficiency makes it difficult for your body to maintain sufficient levels of calcium and phosphate. When this happens, your body makes hormones that cause your bones to release calcium and phosphate. When your bones lack these minerals, they develop weak and soft.

It is most common in children who are 6 to 36 months old. Children are at the highest risk for osteomalacia because they are still growing. Children may not get enough vitamin D if they live in a region with little sunlight, follow a vegetarian diet, or do not drink dairy products. In some cases, the condition is inherited.

It is rare in the United States. Osteomalacia used to be more shared but mostly disappeared in industrialized countries during the 1940s due to the introduction of fortified foods, such as cereals with added vitamin D.

Alternate name

  • Osteomalacia

Types of rickets

Types of rickets include the following:

  • Nutritional rickets
  • Congenital rickets
  • Rickets of prematurity
  • Resistance to vitamin D (type I and type II)
  • Neoplastic rickets
  • Hypophosphatemic rickets
  • Drug-induced osteomalacia

Causes of rickets

Lack of vitamin D or calcium is the most shared cause of osteomalacia. Vitamin D comes largely from exposure of the skin to sunlight, but it is also found in some foods, such as oily fish and eggs. Vitamin D is essential for building strong, healthy bones in children.

In rare cases, children can be born with a hereditary form of osteomalacia. It can also develop if another condition affects the way the body absorbs vitamins and minerals.

Symptoms of rickets

Some signs and symptoms of rickets may contain the following:

  • Pain or tenderness in the bones
  • Slowly growing bones
  • Bowed or curved legs
  • Muscular weakness
  • Bones that are soft and break easily
  • A large forehead or abdomen
  • An unusual shape in the ribs and sternum
  • Wide joints in the elbows and wrists
  • Tooth decay and irregularities

Diagnosis of rickets

Your doctor will ask about your family’s medical history and your child’s health and diet. Your child will need a complete physical exam. Blood tests and bone x-rays also help the physician regulate if your child has osteomalacia.

Treatment for rickets

Treatment depends on the type of rickets your child has. Your physician will find out why your child has osteomalacia and treat the cause. Nutritional rickets is treated with vitamin D and calcium. If your child has inherited osteomalacia or has a disease-causing the problem, a doctor who specializes in osteomalacia may need to help.


Paediatricians, family physicians, and obstetricians are responsible for educating parents (and expectant parents) about measures to prevent osteomalacia. For the pregnant mother, this includes recommending prenatal vitamins and proper nutritional counselling. For the new mother, it is important that she is counselled on vitamin D supplementation for exclusively breastfed babies and, as the child grows and begins to wean, adequate nutritional counselling and reasonable sun exposure for the baby.


If left untreated, osteomalacia can lead to:

  • Failure to grow
  • An abnormally curved spine
  • Bone deformities
  • Dental defects
  • Convulsions
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