Osteomalacia Flashcards
1
Q
What is Osteomalacia?
What are the risk factors?
A
Where there is defective bone mineralisation causing “soft bones” due to insufficient vitamin D
risk factors for vitamin D deficiency
- darker skin
- low sun exposure
- diet
- Renal failure
- Drugs - anticonvulsants
- vitamin D resistant (inherited)
- Liver disease (cirrhosis)
2
Q
How does osteomalacia present?
A
- Fatigue
- Bone pain
- muscle tenderness and weakness
- Fractures
- Looser’s zones: fragility fractures that go partially through the bone
3
Q
What is osteomalacia called when it occurs in children prior to the growth plates closing?
How does it present?
A
Rickets
- growth retardation
- Knock-knee
- bow leg
- features of hypocalcaemia
4
Q
What are the different types of osteomalacia?
A
- vitamin D deficiency
metabolism deficiency
- Renal failure
- Drugs - anticonvulsants (cytochrome P450 inhibitors)
- vitamin D resistant (inherited)
- Liver disease (cirrhosis)
- Tumour induced
5
Q
What investigations can you do for Osteomalacia?
A
- low 25(OH) vitamin D (ALL)
- raised alkaline phosphate (95-100%)
- low calcium, low phosphate (30%)
- parathyroid hormone: raised, secondary hyperparathyroidism
- Xray -
children: cupped, ragged metaphyseal surfaces.
Adults: loss of cortical bone, partial fractures in Looser’s zones (translucent bands)
6
Q
What is the management of Osteomalacia?
A
Vitamin D tablets (colecalciferol)
