Osteomalacia Flashcards
What is osteomalacia?
Defective mineralisation of existing bone
What is rickets?
Defective mineralisation of epiphyseal growth plate cartilage in children, resulting in skeletal deformities + growth retardation.
What is the most common cause of osteomalacia? What can lead to this?
Vitamin D deficiency
Malabsorption
Lack of sunlight
Diet
List 4 conditions causing impaired absorption of vitamin D
CF
Coeliac disease
Chronic pancreatitis
IBD
List 3 conditions causing impaired metabolism of vitamin D
Liver disease e.g. Cirrhosis
CKD
Hypoparathyroidism
Name a medication that can cause impaired metabolism of vitamin D
Anticonvulsants e.g. Phenytoin
Name 2 causes of renal phosphate wasting that can lead to osteomalacia
Renal tubular acidosis
Fanconi syndrome
How may osteomalacia present?
Bone pain + tenderness
Pathologic fractures: esp. femoral neck
Proximal myopathy
List 3 symptoms of myopathy experienced in osteomalacia
Muscle weakness: waddling gait + difficulty walking
Spasms
Cramps
What is a pathologic fracture?
Fracture following mild exertion/ trauma
What investigations should be performed in osteomalacia?
Bloods
X-ray
What bloods are taken in osteomalacia?
Vitamin D: low
Calcium: N/ low
Phosphate: N/ low
ALP: high
What may be seen on X-ray in osteomalacia?
Looser’s zones (pseudo fractures): transverse radiolucent bands representing insufficiency stress fractures
Where are looser’s zones often seen?
Often bilateral + symmetric
Found at femoral neck on medial part of femoral shaft or pubic rami
Describe treatment of osteomalacia
Vitamin D supplementation: ergocalciferol / cholecalciferol
Calcium supplementation: calcium carbonate
