Children
The following symptoms and complaints may indicate rickets:
In addition to symptoms of hypocalcemia (calcium deficiency) with a tendency to tetany, there are typical skeletal changes (development of the epiphyses is disturbed and the cartilage-bone junction of the growth plates is distended).
Symptoms
- Adynamia
- Gait disturbance
- Hair loss
- Itchy exanthema (skin rash)
- Seizures – especially in infants; due to hypocalcemia (calcium deficiency).
- Short stature
- Muscle weakness
- “Frog belly” due to hypotonia of the abdominal muscles with general adynamia of the musculature.
- Constipation (constipation)
- Psychomotor retardation
- Sweating
- Skeletal pain
- Skeletal changes
- Epiphyseal distortions (“double joints“, “rosary”).
- Breast shape deformities (“bell thorax”, “funnel or keel chest“).
- Harrison’s groove – lateral chest indrawing along the diaphragmatic attachment line.
- Disproportionately large skull with flat back of the head: square skull (caput quadratum).
- Kraniotabes – softening of the occipital bones (yielding of the bones of the skull under finger pressure).
- Rachite rosary – swelling of the ribs in the area of the cartilage-bone junction.
- Bending of long tubular bones – in crawling child the arms, in running child the legs.
- Tetany – disturbance of motor function and sensitivity due to hyperexcitability of nerves and muscles.
- Delayed motor development
- Delayed tooth development
- Growth disturbances
- Waddling gait
- Restlessness, jumpiness
- “bow legs due to coxa vara (CCD angle/centrum collum diaphyseal angle (CCDW) collum corpus angle (CC angle, CCW) femoral neck angle; < 120°; normal: 120°-130°).
Adult
The following symptoms and complaints may indicate osteomalacia:
Many patients remain asymptomatic for a long time.
Symptoms
- Symptoms of hypocalcemia (calcium deficiency).
- Myopathy (muscle disease) with muscle weakness – especially in the proximal (“close to the body”) area of the extremities: Waddling gait (synonym: duck gait; stiff, small-stepped gait); there is an increased risk of falling.
- Bone pain (generalized limb pain; panalgia), diffuse; v. a. lumbar spine, pelvis and lower extremities; pain with pressure on exposed bones.
- Fracture tendency (increased tendency to fracture; insufficiency fractures (fractures during normal loading in weakened bone) in the pelvis, os sacrum (sacrum), tibial plateau (upper surface of the tibia), and forefoot; the neck of the femur is also particularly affected)
- Bone deformities of femur / thigh bone (coxa vara) and tibia / tibia (genu varum / the axis enclosed by the upper and lower leg medial angle at the knee joint is smaller than normal; with years of existence, it thus comes to an arc-shaped outward curvature of the affected leg (bow legs)