Nutritional rickets — RACP Paediatrics MCQ

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EasyEndocrineNutritional ricketsRACP Paediatrics

A 2-year-old dark-skinned child presents with bowed legs and widened wrists. Blood tests show low calcium, low phosphate, elevated ALP, elevated PTH, and very low 25-hydroxyvitamin D (<10 nmol/L). What is the most appropriate treatment?

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Correct answer: A — Vitamin D and calcium supplementation

Nutritional (vitamin D deficiency) rickets is the most common form of rickets. Treatment is with high-dose vitamin D (stoss therapy or daily supplementation) plus calcium. In Australia, risk factors include dark skin, maternal vitamin D deficiency, exclusive breastfeeding without supplementation, and limited sun exposure. Prevention through vitamin D supplementation in high-risk groups is important.

Reference: RCH Melbourne – 2023 – Rickets CPG; RACP Paediatric Curriculum – Endocrine