Diagnosis of rickets in infants is carried out on the basis of complaints from parents, an external examination of the child and an analysis to identify the content of vitamin D in the urine. A urine sample according to Sulkovich also helps in the treatment of the disease.
To date, the diagnosis of rickets in infants does not cause difficulties: the doctor just needs to examine the child and talk to his parents to make a diagnosis.
Symptoms of the disease
The first symptoms of rickets can appear in a baby as early as 3-4 months of age. The risk group includes premature babies whose mothers were poorly and undernourished during pregnancy. Insufficient feeding of the baby himself, feeding an unadapted formula, poor in vitamin D, can also provoke the disease. Rickets can be inherited, or it can be a consequence of gastrointestinal diseases that impede the absorption of calcium and phosphorus.
This disease causes sleep disturbance in the child, irritability and tearfulness. Mothers notice that the baby often flinches in the presence of harsh light and sound. There is increased sweating, especially around the face and scalp. As a result, sweat irritates the skin, causes prickly heat and itching, the baby rubs his head on the pillow so that a bald spot appears on the back of the head. The urine pH level changes, it irritates the skin of the perineum, causing the formation of diaper rash. Rickets of a mild degree are also diagnosed by the incipient softening of the bones of the skull along the edge of the fontanelles.
Diagnosis of the disease
In the future, rickets of moderate severity are diagnosed by softening of the bones of the skull and deformation of the baby's head. A flattened occiput and head asymmetry can often be observed. The skeleton continues to deform further, parietal and frontal tubercles appear, the ribs are covered with seals called rickets rosary, and the wrists are rickety bracelets. In a one-year-old baby, mastering the first steps, the lower limbs begin to bend, a characteristic frog belly appears, and the work of internal organs is disrupted.
Diagnosis of severe rickets in infants is carried out on the basis of significant bone deformities, severe lesions of the nervous system and internal organs, a significant lag in psychomotor development. A urine sample according to Sulkovich helps to identify rickets. With this analysis, data on the concentration of calcium in the urine can be obtained. A 2+ score is considered normal. If there is a lack of calcium, the sample will be negative. This same study is used to monitor the treatment of the disease. If the result exceeds 2+, then the child receives vitamin D in excess and either the dosage should be reduced or the drug used should be completely canceled.
