osteomalacia

Question 1

define osteomalacia

Answer 1

poor bone mineralization leading to soft bone due to lack of vitamin D.

Question 2

what is osteomalacia in children called

Answer 2

rickets

Question 3

what is rickets

Answer 3

inadequate mineralization of the bone and epiphyseal cartilage in the growing skeleton of CHILDREN.

Question 4

function of vitamin D

Answer 4

a hormone that the skin creates in response to sunlight.

It regulates:
- bone mineralisation
- hormone secretion
- Immune function

Question 5

what does low vit D lead to

Answer 5

low serum calcium and phosphate, which results in defective bone mineralisation and Osteomalacia.

Question 6

what does low calcium lead to

Answer 6

increased PTH, which promotes calcium reabsorption from the bones, further impairing bone mineralisation.

Question 7

which patients are more likely to get osteomalacia

Answer 7

patients with darker skin and low exposure to sunlight.

Question 8

signs and symptoms of osteomalacia

Answer 8

Patients may experience no symptoms.
- Fatigue
- Bone pain
- Muscle weakness
- Muscle aches
- Pathological/abnormal fractures
- Looser zones (fragility fractures that go partially through the bone)

Question 9

risk factors of osteomalacia

Answer 9

• Malabsorption Disorders (IBD)
• Vit D deficiency in CKD
• darker skin
• low exposure to sunlight
• live in colder climates and spend the majority of their time indoors

Question 10

signs and symptoms of rickets

Answer 10

• Growth retardation
• Hypotonia, Knock-knees,bow-legs.

Question 11

what do blood tests for osteomalacia find

Answer 11

• Low serum 25-hydroxyvitamin D – lab test for vitamin D
  <25 nmol/L = vitamin D deficiency
  25-50 nmol/L = vitamin D insufficiency
• Low serum calcium
• Low serum phosphate
• High serum alkaline phosphatase
• High parathyroid hormone (PTH)

Question 12

which imaging investugations do you do for osteomalacia

Answer 12

x ray - to look for osteopenia

DEXA scan - show low bone mineral density`

Question 13

diagnostic investigation for osteomalacia

Answer 13

BM Biopsy - shows incomplete mineralisation

Question 14

how to treat osteomalacia

Answer 14

Colecalciferol (vitamin D3) either:
- 50,000 IU once a week for 6 weeks.
- 4000 IU daily for 10 weeks.

Then a maintenance dose of 800-2000 IU daily is continued

Question 15

how to check for underlying pathology with osteomalacia

Answer 15

Serum calcium should be checked within a month of the loading regimen to check for any underlying pathology (calcium deficiency, primary hyperparathyroidism, or hypercalcaemia), which may have been masked