Osteomalacia

Osteomalacia is the loss of bone mineralisation, causing soft bones. It's caused by Vit D deficiency, which can be caused by:

• Malabsorption

• Poor diet

• Lack of sunlight - Darker skin, living in colder areas, spending a lot of time indoors

Ricket’s is essentially osteolmalacia in children.

Presentation

• Bone pain - typically lower back, pelvis and lower extremities

• Myalgia and weakness

• Pathological/Abnormal fractures - These occur at Looser zones, which are fragility fractures that go partially through the bone.

Investigations and Management

Bloods:

• 25-OH Vit D (Low)

• Calcium (Low)

• Phosphate (Low)

• PTH (high due to low Ca)

• ALP (raised)

XR - More radiolucent bones, Looser zones, Fragility fractures

Manegement - Vit D supplementation i.e. Cholecalciferol

N.B. Calcium levels should be monitored when starting patients on Vit D.