rickets /rik″əts/ [Gk, rachis, backbone, itis, inflammation] , a condition caused by the deficiency of vitamin D, seen primarily in infancy and childhood and characterized by abnormal bone formation. See also osteodystrophy, osteomalacia, vitamin D. −rachitic, adj. ▪ OBSERVATIONS: Characteristic manifestations in infants and children include soft, pliable bones; softening of skull bones; enlargement of ribs at costochondral junctions; limb deformities; epiphyseal swelling (bowed legs and knock-knees); pigeon breast deformity; Harrison’s groove; spinal deformities; and possible decrease in thoracic volume. Spleen and liver may be enlarged. Body is generally tender to touch. Bone deformities are seen on radiographs. Adults may have bone pain, fractures, weakness, weight loss, and malaise. ▪ INTERVENTIONS: Prevention and treatment are the same and include a diet rich in calcium, phosphorus, and vitamin D and adequate exposure to sunlight. Surgical intervention may be indicated for correction of a slipped femoral epiphysis in infants and young children. Deformities may need correction through bracing. The health care team should focus on prevention, with education about the importance of calcium and vitamin D in diet and prevention of complications associated with existing disease.
