ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Osteomalacia

Osteomalacia

Causes and Risks:
There are numerous causes of osteomalacia. In children, the condition is called rickets and is usually caused by a deficiency of vitamin D . Conditions that may result in osteomalacia include inadequate dietary intake of vitamin D, inadequate exposure to sunlight (ultraviolet radiation), which forms vitamin D in the body, and malabsorption of vitamin D by the intestine. Other conditions include hereditary or acquired disorders of vitamin D metabolism , kidney failure and acidosis , phosphate depletion associated with low dietary intake or kidney disease , and side effects of medications used to treat seizures . Risk factors are related to the causes. In the elderly, there is an increased risk for those who tend to remain indoors and who avoid milk because of lactose intolerance .

The incidence is 1 in 1000 people.

Prevention:
An adequate dietary intake of dairy products that are fortified with vitamin D and exposure of the body to sunlight can prevent osteomalacia caused by vitamin D deficiency in adults.

Use of very strong sunscreen, limited exposure of the body to sunlight, short days of sunlight, and smog are factors that decrease formation of vitamin D within the body.

Symptoms:

diffuse bone pain , especially in the hips
muscle weakness
symptoms associated with low calcium
numbness around the mouth
numbness of extremities
spasms of hands or feet

Signs and Tests:

A bone biopsy shows osteomalacia.
Serum vitamin D level is low.
Serum calcium levels vary with the cause of the disorder.
Serum phosphate levels vary with the cause of the disorder.
A bone X-ray shows osteomalacia.
A CT scan of lumbosacral spine shows changes indicating osteomalacia.

Other tests may be done to determine renal problems or other underlying disorders. They include:

Treatment:
MEDICATIONS:
Oral supplements of vitamin D , calcium, and phosphorus may be given depending on the underlying cause of the disorder. Larger doses of vitamin D combined with exposure to ultraviolet light may be indicated in people with intestinal malabsorption . Monitoring of blood levels of phosphorus and calcium may be indicated with some underlying conditions.

Prognosis:
Improvement in the condition of the bones, evidenced by bone X-rays , can be seen within a few weeks in some people with vitamin deficiency disorders. Complete healing with treatment takes place in 6 months.

Complications:

recurrence of symptoms

Call Your Healthcare Provider:
Call for an appointment with your health care provider if you have symptoms of osteomalacia, or if you think that you may be at risk for this disorder.