Osteomalacia
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| ICD-10 | M83. |
|---|---|
| ICD-9 | 268.2 |
| DiseasesDB | 9351 |
| eMedicine | ped/2014 radio/610 |
| MeSH | D010018 |
Osteomalacia is a condition of defective bone mineralisation which may result in pain, weakness, and fragility of the bones.
[edit] Causes
- Inadequate nutritional amounts of vitamin D or calcium.
- Renal tubular acidosis can lead to excess phosphorus excretion in the urine.
- Can occur following a Parathyroidectomy (excision of the parathyroid gland).
[edit] Clinical features
Osteomalacia in humans starts insidiously, as aches and pains in the lumbar (lower back or spine) region and thighs, spreading later to the arms and ribs. Pain is non-radiating, symmetrical, and accompanied by tenderness in the involved bones. Proximal muscles are weak, and there is difficulty in climbing up stairs and getting up from a squatting position. Physical signs include deformities like triradiate pelvis and spinal kyphosis. The patient has a typical "waddling gait". Pathologic fractures due to weight bearing may develop. Biochemical features are similar to rickets. Radiological feature is characterised by the appearance of "pseudofractures"aka Looser zones.
[edit] Treatment
Nutritional osteomalacia responds well to administration of 2000-4000 IU of vitamin D for 6-12 weeks, followed by a maintanence dose of 400-600 IU daily. Dietary supplementation in the form of Soy milk or milk is recommended. Medicinal calcium in the form of calcium gluconate, lactate, or carbonate can be given.
Malnutrition (Kwashiorkor - Marasmus)
other underconsumption- vitamin Vitamin A deficiency (Bitot's spots), Beriberi, Wernicke's encephalopathy, Pellagra, Ariboflavinosis, Scurvy, Osteomalacia
mineral Iron deficiency, Magnesium deficiency - Chromium deficiency
hyperalimentation (Obesity, Hypervitaminosis A, Hypervitaminosis D)
