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| {{CMG}}
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| __NOTOC__ | | __NOTOC__ |
| '''Associate Editor-In-Chief:''' {{CZ}}
| | {{Osteomalacia}} |
| | {{CMG}}; {{AE}} |
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| | ==[[Osteomalacia overview|Overview]]== |
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| | ==[[Osteomalacia historical perspective|Historical Perspective]]== |
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| ==Overview== | | ==[[Osteomalacia classification|Classification]]== |
| {{Infobox_Disease
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| | Name = Osteomalacia
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| | Image = | |
| | Caption =
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| | DiseasesDB = 9351
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| | ICD10 = {{ICD10|M|83||m|80}}
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| | ICD9 = {{ICD9|268.2}}
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| | ICDO =
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| | OMIM =
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| | MedlinePlus =
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| | eMedicineSubj = ped
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| | eMedicineTopic = 2014
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| | eMedicine_mult = {{eMedicine2|radio|610}}
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| | MeshName =
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| | MeshNumber =
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| | MeshID = D010018
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| }}
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| {{SI}}
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| '''Osteomalacia''' is the defective uptake of minerals into the normal or overgrowing protein bone matrix. It is considered a secondary bone formation impairment. It can lead to increased bone softness and a curvature of the bone. Osteomalacia in children is known as [[rickets]], and because of this, ''osteomalacia'' is often restricted to the milder, adult form of the disease. It may show signs as diffuse body pains, muscle weakness, and fragility of the bones. A common cause of the disease is a deficiency in [[Vitamin D]], which is normally obtained from the diet and/or sunlight exposure.
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| == General characteristics == | | ==[[Osteomalacia pathophysiology|Pathophysiology]]== |
| Osteomalacia in the adult is most commonly found in confined, dark-skinned, or diet-disbalanced subjects. Many of the effects of the disease overlap with the more common [[osteoporosis]], but the two diseases are significantly different. Osteomalacia is specifically a defect in mineralization of the protein framework known as [[osteoid]]. This defective mineralization is mainly caused by lack in vitamin D.
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| Osteomalacia is derived from Greek: ''osteo'' refers to bone, and ''malacia'' means softness. In the past, the disease was also known as ''malacosteon'' and its Latin-derived equivalent, ''mollities ossium''. | | ==[[Osteomalacia causes|Causes]]== |
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| == Causes == | | ==[[Osteomalacia differential diagnosis|Differentiating Any Disease from other Diseases]]== |
| The causes of adult osteomalacia are varied.
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| * Insufficient sunlight exposure, especially in dark-skinned subjects
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| * Insufficient nutritional quantities or faulty metabolism of [[vitamin D]] or [[phosphorus]]
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| * [[Renal tubular acidosis]]
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| * [[Malnutrition]] during [[pregnancy]]
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| * [[Malabsorption]] syndrome
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| * [[Chronic renal failure]]
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| * Therapy with Fumaderm
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| == Clinical features == | | ==[[Osteomalacia epidemiology and demographics|Epidemiology and Demographics]]== |
| Osteomalacia in adults starts insidiously as aches and pains in the lumbar (lower back) 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 [[lordosis]]. The patient has a typical "waddling gait". Pathologic fractures due to weight bearing may develop. | |
| Most of the time, the only alleged symptom is chronic fatigue and bone aches are not spontaneous but only revealed by pressure or shocks.
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| == Biochemical findings == | | ==[[Osteomalacia risk factors|Risk Factors]]== |
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| Biochemical features are similar to [[rickets]].The major fact is a collapsed vitamine D rate in blood or serum.
| | ==[[Osteomalacia screening|Screening]]== |
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| == Radiographic characteristics == | | ==[[Osteomalacia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| === X Ray === | | ==Diagnosis== |
| | [[Osteomalacia history and symptoms|History and Symptoms]] | [[Osteomalacia physical examination|Physical Examination]] | [[Osteomalacia laboratory findings|Laboratory Findings]] | [[Osteomalacia electrocardiogram|Electrocardiogram]] | [[Osteomalacia x ray|X Ray]] | [[Osteomalacia CT|CT]] | [[Osteomalacia MRI|MRI]] | [[Osteomalacia echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Osteomalacia other imaging findings|Other Imaging Findings]] | [[Osteomalacia other diagnostic studies|Other Diagnostic Studies]] |
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| Radiological appearances include
| | ==Treatment== |
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| | [[Osteomalacia medical therapy|Medical Therapy]] | [[Osteomalacia surgery|Surgery]] | [[Osteomalacia primary prevention|Primary Prevention]] | [[Osteomalacia secondary prevention|Secondary Prevention]] | [[Osteomalacia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Osteomalacia future or investigational therapies|Future or Investigational Therapies]] |
| *Indistinct border to the medullary spongiosa
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| *Thinning of the basal lamina and end plates
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| *Loss of definition in the trabecular details
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| *Separation of the compact bone layers
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| *Pseudofractures
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| *[[Protrusio acetabuli]]
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| == Differential Diagnosis of Causes of {{PAGENAME}}== | | ==Case Studies== |
| === Lack of Circulating Vitamin D ===
| | [[Osteomalacia case study one|Case #1]] |
| *Anticonvulsant therapy
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| *Chronic [[Liver Disease]]
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| *[[Chronic Renal Failure]]
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| *Exocrine pancreatic insufficiency
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| *Faulty bile function
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| *Gastrectomy
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| *Insufficient sun exposure
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| *Malnurishment in advanced age
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| *Mesenchymal tumors
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| *[[Nephrotic Syndrome]]
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| *[[Prostate Cancer]]
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| *Small intestine disease
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| *Undernurishment
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| *Vegetarian diet
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| === Peripheral Resistance to Vitamin D ===
| | [[Category:Endocrinology]] |
| *Anticonvulsant therapy
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| *[[Chronic Renal Failure]]
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| *Vitamin D dependent ricketts
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| === Hypophosphatemia ===
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| *Chronic Dialysis
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| *[[Fanconi syndrome]]
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| *[[Malabsorbtion]]
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| *[[Malnutrition]]
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| *[[Neurofibromatosis]]
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| *[[Hypoparathyroidism|Primary Hypoparathyroidism]]
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| *[[Toxin]]s
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| *[[Tumor phosphaturia]]
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| === Miscellaneous ===
| | {{WH}} |
| *[[Calcium]] deficiency
| | {{WS}} |
| *Calcification inhibitors
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| *Chronic [[acidosis]]
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| *[[Hypoparathyroidism]]
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| *Renal transplantation
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| == Treatment ==
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| Nutritional osteomalacia responds well to administration of 200000 IU weekly of vitamin D for 4 to 6 weeks, followed by a maintenance dose of 1600 IU daily or 200000 IU every 4 to 6 months.
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| == Related Chapters ==
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| *[[Osteoporosis]]
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| *[[Osteopetrosis]], the opposite of osteomalacia
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| {{Nutritional pathology}}
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| {{Diseases of the musculoskeletal system and connective tissue}}
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| [[Category:Nutritional and Metabolic Disease]]
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| [[Category:Renal Disease]]
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| [[Category:Disease]]
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| [[Category:Musculoskeletal disorders]]
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| [[ar:لين العظام]]
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| [[es:Raquitismo]]
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| [[de:Osteomalazie]]
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| [[fr:Ostéomalacie]]
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| [[he:רככת]]
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| [[nl:Osteomalacie]]
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| [[pt:Osteomalacia]]
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| [[ru:Остеомаляция]]
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| [[fi:Osteomalasia]]
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| [[sv:Osteomalaci]]
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