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

A disease such as rickets is quite common. Especially often they suffer from children who are born in the north, since it is there that there is a large shortage 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 work of internal organs. Many doctors point out that rickets is a disease of the whole organism, which primarily affects the skeleton and all bones, after which complications affect the nervous and endocrine systems.

Clinical picture

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

1. The initial stage begins with 2 months of age, while it does not last so long - only three weeks. Diagnosis of rickets at this stage is almost impossible, but parents can note common signs in a child. The baby becomes restless, shy, irritable, excessive sweating may occur. The skin of a young child becomes wet, and the back of the head may begin to go bald.
2. The height of the heat 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 baby quickly gets tired and lags behind in psychomotor development, the joints seem loose, a frog tummy appears, the liver and spleen increase. Particular attention should be paid to the skull, it becomes square in shape, an "Olympic forehead" appears, teeth are cut much later than their peers, the curvature of the spine is noticeable.
3. Separately, the recovery period is allocated, which, as a rule, begins in the second year of a child's life. During this period, all the symptoms that manifested 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 is manifested in this way: the child’s psyche can be unstable to stress, scoliosis develops, growth retardation, osteoporosis can gradually manifest. Such children often get sick and they have diseases not only of an immune nature, but also diseases of internal organs.

Parents need to understand how important the diagnosis of rickets in infants is, because the disease is treated early.

Why does rickets appear?

The main reason for 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 organs responsible for its production are disrupted, for example, hereditary metabolic disorders of this vitamin in the body may occur, sometimes diagnosis rickets indicates that the child has chronic liver or kidney disease. The second reason is associated with a deficiency in vitamin D intake with food, as its absorption in the gastrointestinal tract is impaired. A baby can develop diseases from birth almost from birth:

1. Celiac disease is a disease of the small intestine, in which the villi, which are responsible for the absorption of food, die off.
2. Cystic fibrosis can develop due to heredity. As a result of this disease, the bronchopulmonary system and gastrointestinal tract are affected. The digestive glands produce an insufficient amount of enzymes that are necessary for food to be digested in the intestines.
3. Also, the cause may be hiding in prolonged dysbiosis, which was accompanied by severe diarrhea. If the child received food incorrectly, while hygiene rules were violated, then it is likely that rickets will result.

There are other factors due to which a child is diagnosed with rickets:

1. Environmental factors are not excluded, including environmental pollution by heavy metals.
2. Experts note that children who are artificially fed lack vitamin D.
3. Also, parents often prefer to introduce complementary foods in the diet of a small child in the late stages. In this case, the diet turns out to be unbalanced, and this also causes rickets.
4. Parents should carefully monitor that the child is actively moving, as this helps to nourish the bones. Muscular activity helps to supply blood to the bone apparatus. As soon as the child is three months old, parents can do him special gymnastics.
5. Rickets can occur as a result of prolonged drug treatment. In medicine, there are drugs that make it faster to make a metabolism in the liver, 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 delayed in the late stages of pregnancy, so if a mother eats properly and takes care of her health, there will be no risk of premature birth.

Diagnosis at different stages of rickets

Diagnosis of rickets in children under one year of age is mainly carried out, since during this time it is almost impossible not to notice a disease in a child. Rickets has several stages. They should be considered in more detail:

1. The first stage is considered to be early, as it manifests itself by the age of three months. By this time, the reserves of vitamin D received from the mother in the womb are running out, and the disease begins to develop actively. In addition to the fact that the child is deficient in vitamin, he also lost phosphorus, and this substance is involved in many processes. If there is not enough phosphorus, then the brain of the child first of all suffers. 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 stick out their stomachs forward.

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

• “Rickety rosaries” appear. During a routine examination, the pediatrician cannot fail to notice the thickening in those places where the ribs connect to the sternum. This indicates that demineralized bone tissue is growing.
• Sometimes rickety bracelets are noted. This symptom is considered quite common. Long tubular bones begin to thicken in the forearm, so bone tissue begins to grow in thickness.
• At the age of six months, when the child becomes more active, he develops chest kyphosis. If a baby develops rickets at this time, then serious spinal curvature may occur.
• Given that rickets affects all bones of the skeleton, the legs are no exception. They can acquire an O-shaped or X-shaped. Such changes are noted closer to the year when the child begins to get on his feet and take his first steps.
• In a child with rickets, the smell of urine becomes distinct. Since the body lacks phosphorus and calcium, amino acid metabolism is disrupted.

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 adversely affects the work of internal organs, the 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 a normal life, but only if the parents are attentive to the health of their baby.

Diagnostics by the first signs

If you look closely at your child with rickets in the first months of his life, we can note 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 be capricious. During sleep or feeding, you may notice that the baby is sweating 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 its own, will not try to sit down. If a child has such symptoms, then parents should clearly understand that a diagnosis of rickets and timely treatment is required. Naturally, you should not rely only on clinical symptoms, as biochemical laboratory tests will be required. When the parents first suspect that the baby may develop rickets, it is necessary to act like this:

1. Consult a qualified doctor first.
2. Never self-medicate.
3. Carefully monitor that the child receives the necessary dose of vitamin D.
4. The kid should be more in the fresh air.
5. Nutrition should be regular and rational.
6. The kid must constantly move, for this you can do gymnastics every day.
7. Be sure to monitor the mode.

Rickets can be cured if treatment is started on time and the right regimen is provided.

The consequences of rickets

There are often cases when rickets occurs without any consequences, but if the child was not given timely treatment, irreversible consequences can occur in the baby's body.

Almost all children who once suffered from rickets suffer from a decrease in immunity. In addition, a malocclusion is formed in a small child, therefore, jaw deformation occurs, accordingly, speech defects and diction disorders are noted.

Naturally, the skeletal system also suffers, a curve of posture develops, the pelvis bends, which is especially dangerous for girls, because in the future this can complicate childbirth. In this case, the bones become fragile. To get rid of rickets, you need a doctor's consultation and diagnosis, as well as medical treatment.

Diagnostics

Diagnosis of this disease 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 rises.

But at the same time, changes on the X-ray are not indicated. More information can be obtained already when the disease is in full swing. If rickets are diagnosed at this time, the 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, a decrease in the voltage of the teeth is noted, the interval of PQ and the ventricular complex is lengthened, and systolic values ​​are also significantly increased. 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 the child every month, as expected, undergo an examination with a pediatrician, then the specialist will definitely notice deviations.

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

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

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

X-ray changes

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

With rickets, a large amount of calcium and phosphorus is deposited on the bones, so the bone tissue looks dense. When rickets occurs, the salts are washed out - the bone, in turn, becomes not strong, so it can easily be deformed.

Diagnosis of rickets with an x-ray will be able to show how long this pathological process takes. In addition, the doctor will be able to prescribe computed tomography, the data obtained will be more accurate than conventional x-ray images.

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. The treatment of rickets should include the following steps:

1. The primary factor that provoked the appearance of this disease is necessarily 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 are necessarily treated in combination.
4. Additionally, the child is prescribed massage and gymnastics, which will correspond to the age of the baby.

When rickets is detected in a small child, diagnosis and treatment primarily 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 alcoholic, and there are oil preparations. Only a doctor can prescribe this medicine - only he will calculate the correct dose. Otherwise, an overdose can occur, and undesirable side effects will appear. After the differential diagnosis of rickets is carried out, the following measures can be prescribed for treatment:

1. First of all, massage, which should be done by adults, is included, preferably if it is done by a professional.
2. For the child should be gymnastics, which includes active movements. It is important to cause spontaneous movements in the 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 a massage. Children's massage consists of such techniques, which must be performed in sequence:

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

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

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2. If the baby was born prematurely, then doctors must prescribe vitamin D intake, since in this case it will already be missed in a small body.
3. It is advisable that the child leads a more active lifestyle. This will help him form the skeletal system.
4. It is recommended to take more sunbathing - in this case, vitamin D will be produced by the body.
5. From childhood, you can teach a child to temper. This will strengthen the immune system and increase resistance to adverse factors.
   

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 perform the following actions:

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

If the parents have the slightest suspicion that the child has rickets - a clinic, diagnosis, treatment - this is the whole path that adults must go along with their baby. In no case should you self-medicate, since 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, in the event that tests indicate a lack of calcium. These drugs include Complivit and Calcium Gluconate.