Osteomalacia and ricketts Flashcards
What is Ricketts?
The same disease as osteomalacia, but occurring in children which has effects on the growing skeleton.
What can cause insufficient calcium absorption from the intestine?
Lack of dietary intake of calcium or vitamin D
Or
A resistance to the action of vitamin D.
What can cause a phosphate deficiency?
Increased renal loss.
What other things can cause deficiency so in calcium and phosphorous other than malnutrition and malabsorption?
Lack of sunlight, hypophosphataemia, long term anticonvulsant use and chronic kidney disease.
What two things can cause hypophosphataemia?
Re feeding syndrome and alcohol abuse.
What inherited renal disorders can cause osteomalacia/Ricketts?
X linked hypophosphataemia and vitamin D resistant Ricketts.
What signs and symptoms do we see?
Bone pain, deformities from soft bones, pathological fractures and symptoms of hypocalcaemia.
What bones do these patients commonly get pain in?
Pelvis, spine and femurs.
Which is more likely to give deformity from soft bones, osteomalacia or Ricketts?
Ricketts.
What are the symptoms of hypocalcaemia?
Parasthesia, muscle cramps, irritability, fatigue, seizures and brittle nails.
What serum biochemistry results do we expect in osteomalacia/Ricketts?
Typically a low calcium, low serum phosphate and high serum alkaline phosphatase.
What are the treatments for osteomalacia/Ricketts?
Vitamin D therapy with calcium and phosphate supplements.
What is osteomalacia?
A defect of bone with abnormal softening due to deficient mineralisation of osteoid (immature) bone secondary to inadequate intake of calcium and phosphorous.
