Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • hx of breast feeding
  • hx of inadequate sunlight exposure
  • hx of calcium deficiency
  • hx of phosphate deficiency

Other diagnostic factors

  • bone pain
  • growth retardation
  • delayed achievement of motor milestones
  • bony deformities
  • muscle weakness
  • carpopedal spasm
  • tetany
  • numbness or paresthesias
  • hypocalcemic seizures

Risk factors

  • age 6 to 18 months
  • inadequate sunlight exposure
  • breastfeeding
  • darker skin complexion
  • calcium deficiency
  • phosphate deficiency
  • FHx of rickets
  • antacids, loop diuretics, corticosteroids, or anticonvulsants

Diagnostic investigations

1st investigations to order

  • radiograph of a long bone
  • serum calcium
  • serum inorganic phosphorus
  • serum parathyroid hormone level
  • 25-hydroxyvitamin D levels (calcidiol)
  • alkaline phosphatase and liver function tests
  • serum creatinine and BUN
  • urinary calcium and phosphorus
Full details

Investigations to consider

  • 1,25-dihydroxyvitamin D levels (calcitriol)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Carlos Palacio

Associate Professor of Medicine

Associate Program Director

Internal Medicine Residency

Department of Medicine

University of Florida College of Medicine

Jacksonville

FL

Disclosures

CP declares that he has no competing interests.

Assistant Professor of Pediatrics

Mayo Medical School

Director, Pediatric Endocrinology Training Program

Nemours Children’s Clinic

Jacksonville

FL

Disclosures

RO declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Pediatrics

Mayo Clinic

Rochester

MN

Disclosures

PF declares that he has no competing interests.

Consultant in Paediatric Bone Disorders

Department of Paediatric Endocrinology

Royal Manchester Children's Hospital

UK

Disclosures

No disclosures

Professor of Medicine

University of Florida College of Medicine

Jacksonville

FL

Disclosures

AM declares that he has no competing interests.

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