osteomalacia + osteoperosis

Question 1

What is osteomalacia?

Answer 1

• A normal amount of bone but with ↓↓ mineral content.

* Think Low calcium and low phosphate on blood results

Question 2

What happens if there is a normal amount of bone but ↓↓ Ca2+ and ↓↓ Phosphate during a period of bone growth (childhood)?

Answer 2

You get ricketts

Question 3

What are the signs and symptoms of Ricketts?

Answer 3

• Growth retardation
• Hypotonia
• Apathy in infants
• Bow-legged or knock-kneed once walking

Question 4

What is the important thing to remember in a child with rickets?

Answer 4

They are ill. ↓ Ca2+ means that they are hypocalcaemic and need treatment.

Question 5

What are the signs of osteomalacia?

Answer 5

• bone pain, fractures, muscle tenderness, proximal myopathy (waddling gait)

Question 6

What are the key signs you are likely to find on investigation when dealing with osteomalacia?

Answer 6

• low calcium, phosphate, 25(OH) vitamin D
• raised alkaline phosphatase
• x-ray: children - cupped, ragged metaphyseal surfaces; adults - translucent bands (Looser’s zones or pseudofractures)

Question 7

What is the treatment for oseomalacia?

Answer 7

calcium with vitamin D tablets