Osteomalacia (1)

Question 1

What is this?

What is it due to?
→ What can this be caused by?
→ What are the risk factors for it?

What is Ricket’s?

Answer 1

➊ Loss of bone mineralisation, causing soft bones

➋ Vit D deficiency
→ • Malabsorption
• Poor diet
• Lack of sunlight
→ Darker skin, living in colder areas, spending a lot of time indoors

➌ Osteolmalacia in children

Question 2

How does it present?

What are the types of fractures that occur here?

Answer 2

➊ • Bone pain - typically lower back, pelvis and lower extremities
• Myalgia and weakness
• Pathological/Abnormal fractures

➋ Looser zones - fragility fractures that go partially through the bone

Question 3

Investigations and Management:
Which bloods should be done?

What is seen on XR?

What is the main rx?
→ What should be monitored when starting this at a high dose?

Answer 3

➊ • 25-OH Vit D (Low)
• Calcium (Low)
• Phosphate (Low)
• PTH (high due to low Ca)
• ALP (raised)

➋ More radiolucent bones, Looser zones

➌ Vit D supplementation - Cholecalciferol
→ Ca levels