Diagnosis of rickets: causes of the disease, methods of treatment, prevention

2024 Author: Curtis Blomfield | [email protected]. Last modified: 2023-12-16 20:44

Such a disease as rickets is quite common. Children who were born in the north especially often suffer from it, since it is there that there is a great lack of vitamins and solar energy. As a rule, the disease appears in young children as early as infancy, but not all parents can pay due attention to this, since the first signs may not be so pronounced.

It should be noted that the disease affects not only the baby's skeleton, but also the functioning of internal organs. Many doctors point out that rickets is a disease of the whole body, from which the skeleton and all bones first of all suffer, after which complications affect the nervous and endocrine systems.

Clinical picture

Rickets is a complex disease that can manifest itself gradually. Consider the main stages of this disease:

1. The initial stage starts at 2 months of age, and does not last too long - only three weeks. Diagnosis of rickets at this stage is almost impossible, but to note in a childcommon signs parents can. The baby becomes restless, shy, irritable, excessive sweating may appear. The skin of a small child becomes wet, and the back of the head may begin to go bald.
2. The peak period begins a little later, when the child is already six months old. This period is long - it can last up to a year. At this time, the diagnosis of rickets in children is quite likely, since the clinical picture itself becomes pronounced. The kid quickly gets tired and lags behind in psychomotor development, the joints seem loose, a frog's belly appears, the liver and spleen increase. Particular attention should be paid to the skull, it becomes square, an "Olympic forehead" appears, teeth are cut much later than in peers, a noticeable curvature of the spine.
3. Separately, the recovery period is singled out, which, as a rule, begins in the second year of a child's life. During this period, all the symptoms that appeared earlier may gradually disappear, and the general condition of the child is improving.
4. The last period of the disease is associated with residual effects, it begins at the age of three and manifests itself in this way: the child's psyche may be unstable to stress, scoliosis develops, growth retardation, osteoporosis may gradually appear. Such children often get sick and develop diseases not only of an immune nature, but also diseases of internal organs.

Parents should understand the importance of diagnosing rickets in infants because the disease is treated early.

Why does rickets appear?

The main cause of rickets lies in the lack of vitamin D. First of all, vitamin D is absent, because the child does not have enough solar energy, and the functioning of the organs responsible for its production is disrupted, for example, hereditary disorders in the metabolism of this vitamin may occur in the body, sometimes the diagnosis of rickets indicates that the child has chronic liver or kidney disease. The second reason is associated with a deficiency in the intake of vitamin D along with food, since its absorption in the gastrointestinal tract is disturbed. A baby almost from birth can develop diseases such as:

1. Celiac disease is a disease of the small intestine in which the villi that are responsible for the absorption of food die off.
2. Cystic fibrosis can develop due to heredity. As a result of this disease, the broncho-pulmonary system and the gastrointestinal tract are affected. The digestive glands do not produce enough enzymes that are needed for food to be digested in the intestines.
3. Also, the reason may be hiding in a prolonged dysbacteriosis, which was accompanied by severe diarrhea. If the child received food incorrectly, while hygiene rules were violated, then it is likely that rickets will become the consequence of this.

There are other factors that cause a child to be diagnosed with rickets:

1. Environmental factors are not excluded, including heavy metal pollution.
2. Specialists note that children whoartificially fed, vitamin D deficient.
3. Also, parents often prefer to introduce complementary foods into the diet of a small child at a later date. In this case, the diet is unbalanced, and this is also the cause of rickets.
4. Parents should be careful to ensure that the child is actively moving, as this contributes to the nutrition of the bones. Muscular activity helps to carry out the blood supply to the bone apparatus. As soon as the child is three months old, parents can do special exercises for him.
5. Rickets can appear as a result of long-term drug treatment. In medicine, there are drugs that make the metabolism in the liver faster, but because of this, there is a lack of vitamin D.

Young mothers should remember that the course of the pregnancy itself is of great importance. The fact is that in the body of a woman and a child, vitamin D begins to be deposited in late pregnancy, so if the mother eats right and monitors her he alth, there will be no risk of premature birth.

Diagnosis at different stages of rickets

Basically, rickets is diagnosed in children under one year old, since during this time it is almost impossible not to notice the disease in a child. Rickets has several stages. It is worth dwelling on them in more detail:

1. The first stage is considered early, as it appears already by three months. By this time, the stores of vitamin D received from the mother while still in the wombend, and the disease begins to actively develop. In addition to the fact that the child is deficient in the vitamin, he also loses phosphorus, and this substance is involved in many processes. If there is not enough phosphorus, then the child's brain suffers first of all. This period does not last long, only two weeks and passes by itself.
2. The most difficult thing is when the disease goes into the second stage. In this case, the body also becomes low in calcium, which is responsible for the contraction of muscle fibers. That is why children who are diagnosed with rickets bulge forward.

Diagnosis of rickets in children at the second stage allows you to detect disorders such as:

• The "rachitic rosary" appears. During a routine examination, the pediatrician will not be able to miss the thickening in those places where the ribs connect to the sternum. This indicates that demineralized bone tissue is growing.
• Sometimes "rachitic bracelets" are noted. This symptom is considered quite common. Long tubular bones begin to thicken in the forearm, so the bone tissue begins to grow in thickness.
• At the age of six months, when the child becomes more active, he develops thoracic kyphosis. If the baby develops rickets at this time, then he may experience serious curvature of the spine.
• Given that rickets affects all the bones of the skeleton, the legs are no exception. They can acquire an O-shaped or X-shaped shape. Such changes are already noted closer to the year, when the child begins to get on his feet and do his own things.first steps.
• In a child with rickets, the smell of urine becomes distinct. Since the body lacks phosphorus and calcium, the metabolism of amino acids is disturbed.

In no case is it allowed to self-medicate and simply increase the dose of vitamin D. This can only lead to complications. Considering the fact that rickets negatively affects the functioning of internal organs, treatment should be carried out in a complex and only after the diagnosis of "Rickets" is made. Diagnosis and treatment will help the child return to normal life, but only if the parents are attentive to the he alth of their baby.

Diagnosis by the first signs

If you look closely at your child with rickets in the first months of his life, it can be noted that he will be significantly different from his peers. Due to the fact that the disease causes great damage to the nervous system, the child will constantly act up. During sleep or feeding, you may notice that the baby sweats a lot. In this case, the sweat will have a sour smell, in fact, like urine.

In the initial stages, a small child may lose his skills, for example, the baby will not be able to roll over on his own, will not try to sit up. If a child has such signs, then parents should clearly understand that a diagnosis of rickets and timely treatment are required. Naturally, you should not rely only on clinical symptoms, as you will need to undergo biochemical laboratory tests.research. When parents have the first suspicions that the baby may develop rickets, you need to act like this:

1. First of all, see a qualified doctor.
2. Never self-medicate.
3. Make sure your child gets the right amount of vitamin D.
4. Baby should be more outdoors.
5. Food should be regular and rational.
6. The baby must constantly move, for this you can do gymnastics every day.
7. Be sure to follow the regime.

Rickets can be cured if treated on time and given the right regimen.

Consequences of rickets

It is not uncommon for rickets to occur without any consequences, but if the child has not received timely treatment, irreversible consequences may occur in the baby's body.

Practically all children who once had rickets suffer from a decrease in immunity. In addition, an abnormal bite is formed in a small child, therefore, jaw deformity occurs, respectively, speech defects and diction disorders are noted.

Of course, the skeletal system also suffers, a crooked posture develops, the pelvis is bent, which is especially dangerous for girls, because in the future it can complicate childbirth. As a result, the bones become brittle. To get rid of rickets, you need a doctor's consultation and diagnosis, as well as drug treatment.

Diagnosis

Diagnosing thisdiseases can be carried out simultaneously in several directions. As a rule, differential diagnosis of rickets and rickets-like diseases is carried out. At the very beginning, when the disease is just beginning to develop, in blood and urine tests, it can be noted that the level of calcium and phosphorus is reduced, but alkaline phosphatase increases.

But at the same time, changes are not indicated on the X-ray. More information can be obtained already when the disease is in full swing. If rickets is diagnosed at this time, tests can tell a lot. Specialists will be able to note hypocalcemia, hypophosphatemia and acidosis.

Additionally, an electrocardiogram may be prescribed. Its indicators will not be normal, in a child with rickets there is a decrease in the voltage of the teeth, the interval of PQ and the ventricular complex is lengthened, and systolic indicators also increase significantly. At this stage, the differential diagnosis of rickets in children will show changes on the X-ray.

Paraclinical study

Diagnosing rickets is not at all difficult. First of all, attention is drawn to the clinical picture of this disease. Sometimes it is pronounced. Therefore, if a child is examined by a pediatrician every month, as expected, the specialist will definitely notice deviations.

To make an accurate diagnosis, the doctor may prescribe tests. Laboratory diagnosis of rickets is to check the content of calcium and phosphorus in the blood and urine. These are important indicators. Consider the main criteria for diagnosing rickets by this method and the norms of tests that a child may have:

1. For an infant, the blood phosphorus level should be approximately 1 to 2.2 mmol/L. If rickets begins to develop, then these figures decrease to 0.65 mmol / l.
2. The amount of calcium is carefully examined. Normally, the indicators should be kept at around 2.5 mmol / l. If it drops to 2 mmol / l, then this means that there is a large lack of calcium in the body.
3. Alkaline phosphatase is a special enzyme involved in metabolism. The main task of this enzyme is to transfer calcium and phosphorus from the blood to the bone tissue and vice versa. Normally, the indicators should be kept at around 200 units / l. If a child has rickets, then the indicators increase.

It must be remembered that laboratory diagnosis of rickets in children is carried out only after the baby is examined by a pediatrician.

Changes on x-rays

In diagnostics, the X-ray method is actively used, in which it is possible to determine how much the bone tissue has demineralized and what deformations of the skeleton are. The fact is that when the skeleton is in a normal state, all the bones on it have a clear outline.

In rickets, a large amount of calcium and phosphorus is deposited on the bones, so the bone tissue looks dense. With rickets, s alts are washed out - the bone, in turn, becomes not strong, therefore it is easily deformed.

Diagnosisrickets by x-ray, will be able to show how long this pathological process occurs. Additionally, the doctor will be able to prescribe computed tomography, the data obtained will be more accurate than conventional x-rays.

Treatment methods

Rickets must be treated, especially since this disease is treated, and the child will be able to live a full life in the future. If a child has been diagnosed with Rickets, diagnosis, treatment and prevention are three important components that will help him recover. Rickets treatment should include the following steps:

1. The primary factor that provoked the appearance of this disease must be eliminated.
2. The pediatrician can calculate the therapeutic dose of vitamin D, which will help fill the deficiency in the body.
3. If there are chronic diseases that are a complication of rickets, then they must be treated in combination.
4. In addition, the child is assigned massage and gymnastics, which will correspond to the age of the baby.

When rickets is diagnosed in a small child, diagnosis and treatment first of all include the correct calculation of the therapeutic dose of vitamin D. As a rule, the dosage should be 600 thousand or 700 thousand units / day.

Much also depends on the form of release of the vitamin, because there are alcohol and oil preparations. Only a doctor can prescribe this medicine - only he will calculate the correct dose. Otherwise, an overdose may result, and unwanted side effects will appear. After the differentialdiagnosis of rickets, the following measures may be prescribed for treatment:

1. First of all, massage is turned on, which should be done by adults, it is desirable that it be done by a professional.
2. For a child, gymnastics should be carried out, which includes active movements. It is important to cause spontaneous movements in a child during such gymnastics. To do this, use rings and sticks. Passive gymnastic movements are also included separately. They are performed by parents, you can take and bring the arms and legs of the baby to the side, bend and unbend the legs at the knees, and the arms at the elbows.

Despite the results of the diagnosis of rickets, in most cases doctors prescribe massage. Children's massage consists of such techniques that must be performed in the sequence:

1. Start all massage movements with stroking. If the child is overly nervous, then such movements help to calm him down. It is important to remember that the movements should be gliding and light.
2. After stroking, you can move on to rubbing. Such actions help to massage the deeper layers of the skin, which can improve metabolic processes and increase skin elasticity.
3. Kneading helps to engage many muscles. This improves blood flow. In addition, metabolic products begin to be excreted faster, muscle contraction increases. Such techniques can be used to reduce muscles.
4. The last movements in such a massage should be vibrations, that is, oscillatory movements that will improve metabolic processes and regulate tonemuscles.

When there are suspicions that children have rickets, diagnosis, treatment - this is the first thing parents should focus on. If measures are taken in time, then serious consequences can be avoided.

Prevention of rickets

It is necessary to start prevention even before the birth of a child, so women who carry a baby under their hearts should carefully monitor their he alth and eat all foods that are rich in vitamin D. It is from the mother that the child receives this component in the next three months body, and then begins to accumulate it on its own. But do not be very upset if the child has symptoms similar to rickets. Differential diagnosis will help not only determine whether the baby really has a disease, but also indicate at what stage it is. As a preventive measure, parents can do the following:

1. At an older age, add foods that contain vitamin D, calcium and phosphorus to the child's diet.
2. If the baby was born prematurely, then doctors must prescribe vitamin D, as in this case it will already be lacking in a small body.
3. It is desirable that the child lead a more active lifestyle. This will help him build his skeletal system.
4. It is recommended to take more sunbathing - in this case, vitamin D will be produced by the body itself.
5. From childhood, you can teach a child to harden. This will strengthen the immune system and increase resistance to adversefactors.

It is worth remembering that if a child has rickets, diagnosis, treatment and prevention will only be aimed at eliminating the cause and strengthening the small body. Proper care of a small child is considered one of the main aspects, so parents should follow these steps:

1. Constantly monitor the child's behavior.
2. Bring your baby to a routine examination so that the doctor can palpate the fontanelles.
3. Up to six months, it is necessary to carefully monitor changes in the baby's chest to prevent pathological thickening.
4. Monitor your baby's muscle tone.
5. Adjust baby's diet by adding foods rich in vitamin D.
6. Spend more time outdoors.

If parents have the slightest suspicion that a child has rickets - a clinic, diagnosis, treatment - this is the whole path that adults must go through with their baby. In no case should you self-medicate, as you can only complicate the situation and leave your child disabled for life.

Only a doctor can prescribe the right treatment. Often, along with vitamin D, other drugs are prescribed that help improve the metabolic process. Sometimes the pediatrician may prescribe an additional intake of calcium and phosphorus, if the tests indicate a lack of them. These drugs include Complivit and Calcium Gluconate.