Understanding rickets

Rickets is a condition that has been recognised for many centuries and is due to defective mineralisation of the growth plate in growing children. This defect compromises the mechanical support and mineral reservoir functions of the skeleton which leads to the typical skeletal deformities and the disordered mineral metabolism. Either calcium and/or phosphate may be deficient in the aetiology of rickets. Considerable advances in the pathophysiology of hypophosphataemic rickets have been made in recent years. Advances in genetics have led to the identification of many forms of inherited rickets. However nutritional Vitamin D deficiency rickets remains the most prevalent cause worldwide and has made a resurgence in many developed countries in recent years. This article reviews the current knowledge about the different causes of rickets and provides guidelines on diagnosis and management.