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Rickets

Last reviewed: 18 Aug 2025
Last updated: 13 May 2025

Summary

Definition

História e exame físico

Principais fatores diagnósticos

  • history of breast-feeding
  • history of inadequate sunlight exposure
  • history of calcium deficiency
  • history of phosphate deficiency
Detalhes completos

Outros fatores diagnósticos

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

Fatores de risco

  • 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
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • 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
Detalhes completos

Investigações a serem consideradas

  • 1,25-dihydroxyvitamin D levels (calcitriol)
Detalhes completos

Algoritmo de tratamento

AGUDA

symptomatic hypocalcemia

CONTÍNUA

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

Declarações

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

Declarações

FW declares that he has no competing interests.

Agradecimentos

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

Declarações

RO declares that he has no competing interests.

Revisores

Phil Fischer, MD

Professor of Pediatrics

Mayo Clinic

Rochester

MN

Declarações

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

Declarações

No disclosures

Arshag Mooradian, MD

Professor of Medicine

University of Florida College of Medicine

Jacksonville

FL

Declarações

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.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

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

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.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Rickets images
  • Differentials

    • Hypophosphatasia
    • Metaphyseal dysostoses
    • Blount syndrome
    Mais Differentials
  • Guidelines

    • Rickets: standard treatment guidelines
    • Global consensus recommendations on prevention and management of nutritional rickets
    Mais Guidelines
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