A bone disease rife in Victorian Britain has been discovered among children in the South of England.
Doctors found more than 40 cases of rickets in youngsters during the past year. The news comes months after medics in the North East warned the disease was staging a comeback, 80 years after it was declared beaten.
Rickets, which weakens bones, is caused by a lack of Vitamin D. It has been historically linked to poverty, so doctors are surprised it has appeared in affluent Southampton.
Professor Nicholas Clarke, of the city’s general hospital, said Vitamin D supplements should be taken by more children to stop the rise.
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He added: “This is a completely new occurrence.
“We’re seeing cases reminiscent of the 17th century, which would have been inconceivable a year ago.”
“We are seeing cases from areas of deprivation to the middle classes.”
Rickets is a softening of bones in children potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries. The predominant cause is a vitamin D deficiency, but lack of adequate calcium in the diet may also lead to rickets (cases of severe diarrhea and vomiting may be the cause of the deficiency).
Although it can occur in adults, the majority of cases occur in children suffering from severe malnutrition, usually resulting from famine or starvation during the early stages of childhood. Osteomalacia is the term used to describe a similar condition occurring in adults, generally due to a deficiency of vitamin D.
The origin of the word “rickets” is probably from the Old English dialect word ‘wrickken’, to twist. The Greek derived word “rachitis” (???????, meaning “inflammation of the spine”) was later adopted as the scientific term for rickets, due chiefly to the words’ similarity in sound.
Signs and symptoms of rickets include:
* Bone pain and tenderness
* dental problems
* muscle weakness (rickety myopathy or “floppy baby syndrome” or “slinky baby” (where the baby is floppy or slinky-like)
* increased tendency for fractures (easily broken bones), especially greenstick fractures
* Skeletal deformity
o Toddlers: Bowed legs (genu varum)
o Older children: Knock-knees (genu valgum) or “windswept knees”
o Cranial, spinal, and pelvic deformities
* Growth disturbance
* Hypocalcemia (low level of calcium in the blood), and
* Tetany (uncontrolled muscle spasms all over the body).
* Craniotabes (soft skull)
* Costochondral swelling (aka “rickety rosary” or “rachitic rosary”)
* Harrison’s groove
* Double malleoli sign due to metaphyseal hyperplasia
* Widening of wrist raises early suspicion, it is due to metaphysial cartilage hyperplasia.
An X-ray or radiograph of an advanced sufferer from rickets tends to present in a classic way: bow legs (outward curve of long bone of the legs) and a deformed chest. Changes in the skull also occur causing a distinctive “square headed” appearance. These deformities persist into adult life if not treated. Long-term consequences include permanent bends or disfiguration of the long bones, and a curved back.