Rickets: The Skeletal Disorders of Impaired Calcium or Phosphate Availability

  • Erik A. Imel
  • Thomas O. Carpenter


Rickets derives from the old English word “wrikken” meaning to twist or bend and refers to conditions of impaired mineralization of growing bones, ultimately resulting in their bowing and twisting. Rickets and osteomalacia refer to similar processes occurring in different compartments of the bone. Rickets is evident histologically and radiographically as a disorganized and expanded growth plate (physis) of the growing bone, together with the accompanying osteomalacia (accumulation of excess unmineralized osteoid matrix due to a delayed mineral apposition rate) of the trabecular and cortical bone. Children with untreated rickets may develop severe curvature deformities of the lower extremities, primarily due to the effect of weight bearing on an under-mineralized skeleton. This chapter will describe the pathophysiology and clinical diagnostic and treatment approach to rickets from a variety of calciopenic and phosphopenic causes.


Bone Calcium Fibroblast growth factor 23 (FGF23) Hypophosphatemia Osteomalacia Parathyroid hormone (PTH) Mineral metabolism Nutritional deficiencies Phosphate Rickets Vitamin D 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Departments of Internal Medicine and PediatricsIndiana University School of MedicineIndianapolisUSA
  2. 2.Departments of Pediatrics and Orthopaedics and RehabilitationYale University School of MedicineNew HavenUSA

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