Rickets on the Rise: A Case Series Highlighting the Importance of Growth Monitoring and Nutritional Assessment in Preventing Rickets
Nutritional rickets, though a preventable condition, continues to show an increased incidence in clinical practice. It is crucial to recognize these cases during early stages in order to prevent the progression from vitamin D deficiency to clinical rickets, with the potential for irreversible complications. This case series describes five pediatric patients in which vitamin D deficiency and rickets was identified by close observation through growth monitoring and nutritional assessment. These workups were conducted due to the initial presentation of failure to thrive in each of these cases, prompting further evaluation to identify the underlying causes of growth faltering. A common theme throughout was normocalcemia, however, it is important to understand that this finding does not rule out the potential for rickets, as both subclinical rickets and stage two compensatory rickets can lead to normal laboratory findings. Therefore, growth faltering should always prompt nutritional assessment because early recognition, growth monitoring, a well-balanced diet with calcium-rich foods, compliance with vitamin D supplementation, and consistent follow-ups are essential to prevent the risk of developing clinical rickets.