Disease Information for Osteomalacia

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Clinical Manifestations
Signs & Symptoms
Buttock Pain
Arm/shoulder weakness (symptom)
Diffuse Aches and Pains
Hip Inner Thigh Pain
Proximal muscle weakness
Shoulder/limb girdle weakness/bilateral
Rib tenderness
Acute Back Pain
Back Pain
Backache
Bone Pains
Bowing of extremities
Chronic Back Pain
Loss of height
Low Back Pain
Sacrum area back pain
Skeletal problems/symptoms/signs
Tender Bones (Long Bones)
Typical Clinical Presentation
Presentation/Fractures Pathologic Minimal Trauma
Demographics & Risk Factors
Ethnic or Racial Factors
Asian Indian population
Chinese population
Past History
Past history/Sprue/gluten enteropathy
Established Disease Population
Patient/Hyperparathyroidism
Patient/Malabsorption syndrome
Patient/Dialysis shunt/hemodialysis
Patient/Uremia/Chronic renal disease
Population Group
Population/Immigrant population
Laboratory Tests
Abnormal Lab Findings - Decreased
1,25 (OH)2 Vitamin D serum level (Lab)
pH, arterial blood (Lab)
Phosphate Serum (Lab)
URINE Phosphorus
Abnormal Lab Findings - Increased
Alkaline phosphatase, bone isoenzyme/serum (Lab)
Alkaline phosphatase, serum (Lab)
URINE Hydroxyproline
Diagnostic Test Results
CT Scan
CT Scan/Bone densometry/density decreased
CT/Dexa-Scan Bone density Abnormal
X-RAY
Xray/Bone abnormality
Xray/Diffuse thin/poorly calcified bones
Xray/Fish vertebra deformity/Spine
Xray/Generalized bone resorption
Xray/Looser's/Pseudofractures/Skeletal
Xray/Schmorl's nodes vertebrae/spine
Xray/Skeletal findings
Associated Diseases & Rule outs
Associated Disease & Complications
Hypophosphatemia
Kidney stone/Nephrolithiasis/Urolithiasis
Lumbar compression fracture
Male osteoporosis syndrome
Osteomalacia
Osteoporosis, senile/postmenopausal
Osteoporosis/osteopenia
Pathologic fractures
Platybasia
Secondary hyperparathyroidism
Metabolic Bone Disease
Disease Synergy - Causes
Synergy/Uremia
Disease Mechanism & Classification
Class
CLASS/Bone disorder (ex)
CLASS/Diffuse bone involvement/disorder (ex)
CLASS/Skeletal (category)
Pathophysiology
Pathophysiology/Osteoporosis Secondary
Process
PROCESS/Deficiency (category)
PROCESS/Reference organ/system (category)
Treatment
Drug Therapy - Indication
RX/Calcitrol (Calcijex)
RX/Calcium supplement
RX/Vitamin D
Definition

A condition marked by softening of the bones (due to impaired mineralization, with excess accumulation of osteoid), with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium; This fat-soluble vitamin occurs mainly in two forms: ergocalciferol (activated ergosterol, vitamin D2), found in irradiated yeast; and cholecalciferol (activated 7-dehydrocholesterol, vitamin D3), formed in human skin by exposure to sunlight (ultraviolet radiation); In the liver, vitamin D3 is converted to 25(OH)D3, the major circulating form; It passes through the enterohepatic circulation and is reabsorbed from the gut. Principally in the kidneys, it is further hydroxylated to the much more metabolically active form, 1,25(OH)2D3 (1,25-dihydroxycholecalciferol, calcitriol, vitamin D hormone); The main function of vitamin D hormone is to increase calcium absorption from the intestine and promote normal bone formation and mineralization; Metabolic bone disease resulting from vitamin D deficiency is called rickets in children and osteomalacia in adults; Vitamin D deficiency may also be caused by defects in the production of 25(OH)D3 or the action of 1,25(OH)2D3; The deficiency may occur in in hereditary diseases, such as familial hypophosphatemic (vitamin D-resistant) rickets, an X-linked dominant disorder [Type II]; In children, changes include defective calcification of growing bone and hypertrophy of the epiphyseal cartilages; Epiphyseal cartilage cells cease to degenerate normally, but new cartilage continues to form, so that the epiphyseal cartilage becomes irregularly increased in width; Calcification then stops, and osteoid material accumulates around the capillaries of the diaphysis; The cancellous bone of the diaphysis and cortical bone may be resorbed in chronic deficiency; Adequate treatment with vitamin D permits calcium and phosphate deposition through degeneration of the cartilage cells; Osteoid material at the diaphysis ceases to form, and normal endochondral production of new bone is resumed; In adults, the changes are similar but are not confined to the ends of the long bones;aternal osteomalacia can lead to metaphyseal lesions and tetany in the newborn;

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External Links Related to Osteomalacia
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Wikipedia
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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