Ostemalacia

Question 1

What is the rpesentation of osteomalacia?

Answer 1

proximal muscle weakness, in association with bone pain and bone weakening, as suggested by the sustained fracture as well as the waddling gait.

Question 2

What is the cause of osteomalacia?

Answer 2

It is caused by low vitamin D and therefore poor mineralisation of the bone which lead to pain, fracture and deformity of the bones including bowing of the legs. The most common cause of Osteomalacia is insufficient dietary calcium or a deficiency of vitamin D which is very common in the UK due to poor UV light exposure. CKD and malabsorption can also cause this

Question 3

What is the risk factor for vitamin D deficiency?

Answer 3

Age over 65
Darker skin
Housebound patients
Malabsorption disease

Question 4

What are the clinical signs of osteomalacia?

Answer 4

A waddling gait
Proximal muscle weakness
Generalised bone and joint tenderness
Signs of hypocalcaemia (e.g. tetany, carpopedal spasm)
Spinal deformities e.g. kyphoscoliosis