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==Differential Diagnosis==
==Differential Diagnosis==
* Osteomalacia must be differentiated from other diseases that cause lowering [[Bone mineral density|bone mineral density (BMD)]], such as [[osteoporosis]], [[scurvy]], [[osteogenesis imperfecta]], [[multiple myeloma]], and [[homocysteinuria]].
* Osteomalacia must be differentiated from other diseases that cause lowering [[Bone mineral density|bone mineral density (BMD)]], such as [[osteoporosis]], [[scurvy]], [[osteogenesis imperfecta]], [[multiple myeloma]], and [[homocysteinuria]].
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Osteoporosis'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* On physical examination, demonstrates acute musculoskletal pain, if [[Bone fracture|fracture]] happened
* On imaging studies, demonstrates severe decrease in [[Bone mineral density|BMD]]
| style="padding: 5px 5px; background: #F5F5F5;" |-
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Idiopathic]] transient osteoporosis of [[Hip (anatomy)|hip]]'''
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* On physical examination, demonstrates acute [[hip]] pain
* On imaging studies, demonstrates sub-chondoral [[Cortical bone|cortical]] loss and diffuse [[osteopenia]] of the [[femoral]] neck
| style="padding: 5px 5px; background: #F5F5F5;" |
* On history, demonstrates mostly involvement of [[pregnant]] women and young men
* On history, demonstrates to be [[self-limiting]] in 6-8 months
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Osteomalacia]]'''
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* On physical examination, demonstrates diffuse [[bone]] [[pain]], fatigue, and [[fractures]] are the common symptoms
* On imaging studies, demonstrates low [[Bone mineral density|bone mineral density (BMD)]]
| style="padding: 5px 5px; background: #F5F5F5;" |
* On imaging studies, demonstrate the brief [[Bone loss|bone mass loss]] in [[bones]]
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Scurvy]]'''
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* On physical examination, demonstrates [[bone pain]] and frequent [[fractures]] due to brittle [[bone]]
* On imaging studies, demonstrates low [[Bone mineral density|bone mineral density (BMD)]]
| style="padding: 5px 5px; background: #F5F5F5;" |
* On physical examination, demonstrates other [[mucosal]] disruption symptoms, such as [[bleeding gums]]
* On imaging studies, demonstrates normal [[Bone mineral density|bone mineral density (BMD)]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Osteogenesis imperfecta]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* On physical examination, demonstrates [[Short stature]], [[scoliosis]], and propensity for [[Bone fracture|fractures]]
| style="padding: 5px 5px; background: #F5F5F5;" |
* On physical examination, demonstrates [[tooth]] defects, [[Hearing impairment|hearing defects]], and blue [[sclera]]
* On laboratory studies, demonstrates near normal [[Bone mineral density|bone mineral density (BMD)]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Multiple myeloma]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* On physical examination, demonstrates diffuse [[bone]] pain and [[tenderness]]
* On imaging studies, demonstrates osteolytic lesions in the [[bones]]
| style="padding: 5px 5px; background: #F5F5F5;" |
* On laboratory studies, demonstrates monoclonal [[IgM]] overload in [[electrophoresis]], and also [[Bence-Jones protein]] in urine
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Homocystinuria]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* On physical examination, demonstrates diffuse [[bone]] [[pain]] and [[musculoskeletal]] symptoms
| style="padding: 5px 5px; background: #F5F5F5;" |
* On physical examination, demonstrates [[visual impairment]]
* On laboratory studies, demonstrates high amounts of [[homocysteine]] in [[urine]]
|}
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==References==
==References==

Revision as of 20:26, 31 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Osteomalacia must be differentiated from other diseases that cause lowering bone mineral density (BMD), such as osteoporosis, scurvy, osteogenesis imperfecta, multiple myeloma, and homocysteinuria.

Differential Diagnosis

Differential Diagnosis Similar Features Differentiating Features
Osteoporosis
  • On physical examination, demonstrates acute musculoskletal pain, if fracture happened
  • On imaging studies, demonstrates severe decrease in BMD
-
Idiopathic transient osteoporosis of hip
  • On physical examination, demonstrates acute hip pain
  • On imaging studies, demonstrates sub-chondoral cortical loss and diffuse osteopenia of the femoral neck
  • On history, demonstrates mostly involvement of pregnant women and young men
  • On history, demonstrates to be self-limiting in 6-8 months
Osteomalacia
Scurvy
Osteogenesis imperfecta
Multiple myeloma
  • On physical examination, demonstrates diffuse bone pain and tenderness
  • On imaging studies, demonstrates osteolytic lesions in the bones
Homocystinuria

References

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