Osteomalacia & Rickett's

Question 1

What is osteomalacia?

Answer 1

Qualitative defect

- Inadequate amounts of calcium & phosphorous > Deficient mineralization of osteoid > abnormal softening of bone

Question 2

What is Rickett’s?

Answer 2

Osteomalacia in children

Question 3

Principal causes of osteomalacia?

Answer 3

• Insufficient Ca absorption from intestine: lack of dietary calcium
• Deficiency of Vit D
• Resistance to the action of Vit D
• Phosphate deficiency

Question 4

Specific causes of osteomalacia?

Answer 4

• Malnutrition (Ca/Vit D)
• Malabsorption
• Lack of sunlight exposure
• Hypophosphataemia (refeeding syndrome, alcohol abuse)
• Long-term anticonvulsant use
• CKD
• Inherited Renal disorders

Question 5

Symptoms of osteomalacia?

Answer 5

• Bone pain: pelvis, spine, femur
• Deformities from soft bones
• Pathological fractures
• Hypocalcaemia: paraesthesia, muscle cramps, irritability, fatigue, seizure, brittle nails
• Radiographs: pseudofractures

Question 6

Investigation of osteomalacia?

Answer 6

Abnormal serum bone biochemistry

• Low calcium
• Low serum phosphate
• High serum alkaline phosphatase

Question 7

Treatment of osteomalacia?

Answer 7

Vitamin D therapy
Calcium supplementation
Phosphate supplementation