Osteomalacia

Question 1

What is Osteomalacia

Answer 1

normal bony tissue but decreased mineral content
rickets if when growing
osteomalacia if after epiphysis fusion

Question 2

Types of osteomalacia

Answer 2

vitamin D deficiency e.g. malabsorption, lack of sunlight, diet
renal failure
drug induced e.g. anticonvulsants
vitamin D resistant; inherited
liver disease, e.g. cirrhosis

Question 3

Features osteomalacia

Answer 3

rickets: knock-knee, bow leg, features of hypocalcaemia
osteomalacia: bone pain, fractures, muscle tenderness, proximal myopathy

Question 4

Ix

Answer 4

low 25(OH) vitamin D (in 100% of patients, by definition)
raised alkaline phosphatase (in 95-100% of patients)
low calcium, phosphate (in around 30%)
x-ray: children - cupped, ragged metaphyseal surfaces; adults - translucent bands (Looser's zones or pseudofractures)

Question 5

Treatment of osteomalacia

Answer 5

Calcium with Vit D tablets