Definition:
Rickets in children is a disorder of bone growth caused by poor mineralization, making bones softer and more prone to bending or deformity. It most commonly appears in the early years of life, especially in children with poor nutrition or insufficient sun exposure.

2) Symptoms That Require Attention:

• Delay in sitting, crawling, or walking.
• Bowing of the legs or inward/outward bending.
• Delayed tooth development or dental formation problems.
• Leg pain or slower growth compared to peers.
• Protruding chest bones (pectus carinatum).
• Weak muscles and easy fatigue.

3) Common Causes of Rickets:

• Vitamin D deficiency due to limited sun exposure.
• Calcium deficiency or general malnutrition.
• Problems with mineral absorption in the digestive system.
• Genetic disorders affecting bone mineralization.
• Exclusive breastfeeding without vitamin D supplementation.
• Childhood obesity reducing vitamin D absorption.

4) How It Is Diagnosed:

• Clinical examination to observe deformities or signs of rickets.
• Blood tests to measure levels of vitamin D, calcium, and phosphorus.
• X-rays to assess bone density and shape.
• Kidney and endocrine function tests in atypical cases.

5) Degrees of Rickets:

• Mild: Mild symptoms, treatable with supplements.
• Moderate: Visible bowing and delays in movement.
• Severe: Obvious leg deformities and major disruption of bone growth.

6) Treatment Options Before Considering Surgery:

• Vitamin D supplements at doses prescribed by the doctor.
• Calcium supplements to improve bone mineralization.
• Daily safe sun exposure for the child.
• Correcting malnutrition and providing a balanced diet.
• Physical therapy to strengthen muscles and support bones.

7) When Is Surgery Needed?

• Persistent bowing after completing medical treatment.
• Severe deformities affecting walking or causing chronic pain.
• Curvatures that cannot be corrected through natural growth.

8) Prognosis and Expected Improvement:

• Most children respond quickly to treatment if the condition is detected early.
• Bones can return to normal within several months of therapy.
• Monitoring vitamin D and calcium levels is essential to prevent recurrence.
• Early treatment leads to better outcomes and reduces the risk of permanent deformities.

9) Important Tips for Parents:

• Follow the prescribed treatment doses carefully.
• Expose the child to safe sun periods (early morning or late afternoon).
• Provide a calcium-rich diet, including milk, eggs, and fish.
• Regularly monitor the child’s progress to ensure bone improvement.
• Consult the doctor immediately if severe pain or increased bowing occurs.