Osteomalacia

Exam Cram

• Osteomalacia: vit d deficiency in adults, 

• Rickets: vitamin d deficiency in children

• Presentation: proximal muscle weakness

• Management: vitamin D & calcium supplementation

Outline

Background 

Referred to as 'soft bone disease'. 

Assessment

History:

• Reduced exercise tolerance

• Pains in hips & shoulders

Examination:

• 4/5 proximal muscle weakness in hips & shoulders

Investigations

• Low Vitamin D

• Low Calcium

• Low Phosphate

• High Alk P

• High PTH

• XR: coarsened trabecular bone

Diagnosis

Diagnostic criteria: biochemical 

Differentials

• Hyperparathyroidism: high calcium

• Paget's Disease: usually effects single joint

• Ricket's: vitamin D deficiency < 18yrs

Classification by cause:

• Dietary or UV light deficiency

• CKD (renal osteodystrophy)

• Malabsorption

Management

• PO replacement of vitamin D and calcium

• UV sunlight

References

1. Zimmerman L, Anastasopoulou C, McKeon B. Osteomalacia. [Updated 2024 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551616/

Page written in 2024.