Calcification then stops, and osteoid material accumulates around the capillaries of the diaphysis. The cancellous bone of the diaphysis and cortical bone may be resorbed in chronic deficiency. Adequate treatment with vitamin D permits calcium and phosphate deposition through degeneration of the cartilage cells within 24 h and penetration by a vascular network within 48 h. Osteoid material at the diaphysis ceases to form, and normal endochondral production of new bone is resumed. In adults, the changes are similar but are not confined to the ends of the long bones. Symptoms and Signs Maternal osteomalacia can lead to metaphyseal lesions and tetany in the newborn.
Young infants are restless and sleep poorly.
In older children and adolescents, walking is painful, and in extreme cases, such deformities as bowlegs and knock-knees develop. Rachitic tetany is caused by hypocalcemia and may accompany infantile or adult vitamin D deficiency. The clinical findings are discussed in Hypocalcemia under Disorders of Calcium Metabolism in Ch. Bone changes in rickets are most evident at the lower ends of the radius and ulna. Later, the distance between the ends of the radius and ulna and the metacarpal bones appears increased because the true ends are noncalcified and invisible.