When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Rickets

Última revisión: 21 Sep 2025
Última actualización: 13 May 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • history of breast-feeding
  • history of inadequate sunlight exposure
  • history of calcium deficiency
  • history of phosphate deficiency
Todos los datos

Otros factores de diagnóstico

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

Factores de riesgo

  • age 6 to 23 months
  • inadequate sunlight exposure
  • breast-feeding
  • darker skin complexion
  • calcium deficiency
  • phosphate deficiency
  • family history of rickets
  • antacids, loop diuretics, corticosteroids, or anticonvulsants
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • 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 blood urea nitrogen
  • urinary calcium and phosphorus
Todos los datos

Pruebas diagnósticas que deben considerarse

  • 1,25-dihydroxyvitamin D levels (calcitriol)
Todos los datos

Algoritmo de tratamiento

Agudo

symptomatic hypocalcemia

En curso

calcium-deficient rickets: vitamin D deficiency

calcium-deficient rickets: calcium deficiency

calcium-deficient rickets: pseudovitamin D deficiency

calcium-deficient rickets: vitamin D resistance

hypophosphatemic rickets: X-linked

hereditary hypophosphatemic rickets with hypercalciuria

hypophosphatemic rickets: tumor-induced

Colaboradores

Autores

Carlos Palacio, MD, MPH, FACP
Carlos Palacio

Professor of Medicine

Associate Program Director

Internal Medicine Residency

Department of Medicine

University of Florida College of Medicine

Jacksonville

FL

Divulgaciones

CP declares that he has no competing interests.

Firas Warda, MD

Endocrinology Fellow

Division of Endocrinology, Diabetes, and Metabolism

Department of Medicine

University of Florida College of Medicine

Jacksonville

FL

Disclosures

FW declares that he has no competing interests.

Acknowledgements

Professor Carols Palacio and Dr Firas Warda would like to gratefully acknowledge Dr Robert Olney, a previous contributor to this topic.

Disclosures

RO declares that he has no competing interests.

Peer reviewers

Phil Fischer, MD

Professor of Pediatrics

Mayo Clinic

Rochester

MN

Disclosures

PF declares that he has no competing interests.

Zulf Mughal, MD

Consultant in Paediatric Bone Disorders

Department of Paediatric Endocrinology

Royal Manchester Children's Hospital

UK

Disclosures

No disclosures

Arshag Mooradian, MD

Professor of Medicine

University of Florida College of Medicine

Jacksonville

FL

Disclosures

AM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American College of Obstetricians and Gynecologists. ACOG committee opinion no. 495: vitamin D: screening and supplementation during pregnancy. Jul 2011 [internet publication].Full text

Munns CF, Shaw N, Kiely M, et al. Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab. 2016 Feb;101(2):394-415.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

O uso deste conteúdo está sujeito ao nosso aviso legal