Osteomalacia Vs Osteogenesis Imperfecta

Question 1

Osteomalacia Definition

Answer 1

• Softening of bone
• Caused by impaired bone mineralization (deficiency from lack of sun, poor nutrition, low phosphate, decreased vit D, or drug induced)
• Vitamin D is most common cause in older adults
• Side note —> Rickets is the ineffective bone mineralization in children

Question 2

Osteomalacia Clinical Presentation

Answer 2

• Subtle indicators and diagnosis can easily be missed
• Diffuse bone pain and fatigue
• Proximal muscle pain
• Waddling gait due to hip weakness and pain
• Fracture may be first presenting sign
• Bone deformity may be apparent in long bones or pelvis
• ADLs may be affected due to weak and stiff muscles

Question 3

Osteomalacia Treatment

Answer 3

• Increase in vit D intake — medication and sun exposure
• Dietician
• Tailored exercise program to ensure strengthening of muscles
• ADL improvement
• Weight bearing exercises
• No intensive or high impact exercises

Question 4

Osteogenesis Imperfecta Definition

Answer 4

• Congenital, rare, genetic disorder (gene mutation)
• Impacts connective tissue and bone
• Referred to as “brittle bone disease”
• Susceptible to fractures and reduced bone density
• Also may present with osteoporosis, blue sclera (white part of eye), and teeth or hearing can be affected
• Can impact mobility and ADLs

Question 5

Osteogenesis Imperfecta Pathology

Answer 5

• Synthesis of type I collagen affected
• Contributes to tissues, skin, bones, tendons, skin, and sclerae

Question 6

Osteogenesis Imperfecta Clinical Presentation

Answer 6

• Osteoporosis / bone fragility — fractures and bone deformities
• Discoloration of sclera — may be blue or grey in color
• Dentinogenesis imperfecta — discoloration of teeth or translucent and weakened teeth
• Hearing impairments
• Ligament laxity
• Joint hypermobility
• Prone to bruising
• Short stature

Question 7

Osteogenesis Imperfecta Diagnosis

Answer 7

• x-rays
• lab tests
• DEXA scan
• bone biopsy (taken at hip)

Question 8

Osteogenesis Imperfecta Prognosis

Answer 8

• Early achievement of milestones is associated with ability to walk independently
• Depending on type of OI

Question 9

Osteogenesis Imperfecta Complications

Answer 9

• Respiratory infections
• Cardiac issues — valve defects
• Kidney stones
• Tumor
• Joint conditions
• Eye conditions and vision loss
• Malignant hyperthermia

Question 10

Osteogenesis Imperfecta Treatment

Answer 10

• Prevent deformities and fractures
• Maintenance of independence
• Surgery to prevent fractures and correct deformities
• Fracture care
• Biophosphates to strengthen bones and prevent fractures
• Growth hormone therapy
• Dental treatment
• Assistive devices