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Osteomalacia
 

Information About

Rickets




  ICD10 E550
  ICD9


Osteomalacia ( Pronounced ), also known as '''bow-leggedness''' or '''rickets''' (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.


AETIOLOGY


Vitamin D is created by the body when it is exposed to UV Light , which is more commonly known as being present in Sunlight . In 1916, German medical research scientist and pediatrician Kurt Huldschinsky (1883-1940) discovered that exposing patients who had osteomalacia to artificially generated ultra-violet light, also known as Heliotherapy , and was able to yield quicker recovery than other methods, such as supplementation of dairy products within a patient's diet.

Vitamin D3 is produced naturally by the human body on exposure to UVB in sunlight. Vitamin D is also added to Milk , milk products, and multi-vitamin pills through a process originally Patent ed by Harry Steenbock . Some people who do not get enough sun exposure, milk products, or green vegetables may also develop the disease. Deficiency of calcium can also cause rickets, particularly in some developing countries where the intake of calcium-rich products such as leafy greens, nuts, and seeds is low.

Hereditary rickets is caused by an inherited disease that interferes with phosphate absorption in the Kidney or by Renal tubular acidosis, in which calcium is taken from the bones to counteract acid produced in the kidneys. Rickets can also be caused by certain Liver diseases.


MANIFESTATIONS OF DISEASE

Rickets causes bone pain, slowed growth in children, Dental problems, Muscle loss and increased risk of Fracture s (easily broken bones). Medical problems seen in children with rickets are

#Vitamin D deficiency,
#Skeletal deformity,
#Growth disturbance,
#Hypocalcaemia (low level of calcium in the blood),
#Tetany (uncontrolled muscle spasms).

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

Treatment involves increasing dietary intake of calcium, Phosphate s 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 don't 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:


A doctor may diagnose rickets by:


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.


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