Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about Ricketts. And you can find written notes on this topic at zero tofinals.com

slash Ricketts or in the orthopedic section of the Zero to Finals Pediatrics book.

So let's get straight into it.

Ricketts is a condition affecting children

where there is defective bone mineralization

which causes soft and deformed bones.

In adults, the same process leads to a condition called osteomalacia.

Osteo means bone and malacia means soft. So what are the causes?

Ricketts is caused by a deficiency in vitamin D or calcium. Vitamin D is either produced in the body

in response to sunlight or obtained through foods such as eggs, oily fish and fortified cereals or nutritional supplements.

Calcium is found in dairy products and some green vegetables.

There's a rare form of rickets that's caused by genetic defects that result in low phosphate in the

blood. This is called hereditary hypophosphatemic rickets.

The most common form of hereditary hypophosphatemic rickets is X-Link dominant,

however it also has other modes of inheritance.

So let's start with some simplified pathophysiology.

Vitamin D is a hormone, not technically a vitamin, created from

cholesterol by the skin in response to UV radiation. Patients with darker skin require longer

periods of sun exposure to generate the same quantity of vitamin D. A standard diet contains

inadequate levels of vitamin D to compensate for a lack of sun exposure.

Reduce sun exposure without vitamin D supplementation leads to vitamin D deficiency.

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