Rickets and Osteomalacia: Causes and Symptoms

What are rickets and osteomalacia?

Rickets is a disease of growing children that affects how the growth plates of bones develop. Rickets can cause bowing of the legs and bone pain. It can also increase a child’s risk of fracture (broken bone).

Osteomalacia affects both children and adults and is a disease in which the bones don’t contain enough bone mineral (mostly calcium and phosphate). Like rickets, osteomalacia can cause bone pain and increase the risk of fracture.

These two conditions are closely linked – usually a child with rickets will also have osteomalacia.

What causes rickets and osteomalacia?

The most common cause of rickets and osteomalacia is vitamin D deficiency (not enough vitamin D). Usually, this is due to:

• A diet without enough vitamin D.
• Insufficient vitamin D production in your skin (from having darker colored skin or keeping skin covered without sufficient sun exposure, or living in northern regions of the country). This is particularly a problem during the winter months.
• Some medical conditions, such as celiac disease, can affect how a child’s gut absorbs vitamin D from food.
• In a few cases, rickets is the result of rare genetic conditions that affect how the body uses vitamin D or phosphate.

What are the symptoms of rickets and osteomalacia?

The symptoms most commonly seen in rickets and osteomalacia are the direct result of how the condition affects bone development. Children with rickets can have bowing of the legs which worsens over time, wider wrists, and frontal bossing (an unusually prominent forehead). They also can have poor growth. Osteomalacia causes bone pain and can increase the risk of fracture.

Rev. 7/2019. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this webpage. This webpage is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.