Discuss the basic epidemiology, pathophysiology, presentation, investigation, management and prognosis of osteomalacia

Question 1

What would you expect a patient with osteomalacia’s calcium levels to be?

Answer 1

Low or low/normal

Question 2

What would you see on an X-ray of someone with osteomalacia?

Answer 2

looser zones

Question 3

What would you expect a patient with osteomalacia’s phosphate levels to be?

Answer 3

low or low/normal

Question 4

What is the most common cause of osteomalacia?

Answer 4

Vitamin D deficiency

Question 5

How do you manage osteomalacia?

Answer 5

10,000-25,000 IU daily for 2-4 weeks for rapid clinical improvement

Question 6

What is osteomalacia?

Answer 6

the result of the failure of mineralisation of the bone, affecting adults. It causes marked softening of the bones

Question 7

What are 3 symptoms of hypocalcaemia?

Answer 7

1. lethargy
2. tetany (involuntary contraction of muscles)
3. convulsions

Question 8

what would you expect a patient with osteomalacia’s parathyroid hormone levels to be?

Answer 8

raised

Question 9

what would you expect a patient with osteomalacia’s serum alkaline phosphatase levels to be?

Answer 9

raised

Question 10

what would you expect a patient with osteomalacia’s serum vitamin D levels to be?

Answer 10

low

Question 11

Where is bone pain most common in patients with osteomalacia?

Answer 11

long bone and pelvis

Question 12

How does osteomalacia present? (6)

Answer 12

• vague bone pain
• skeletal deformity
• muscle pain
• fracturing
• hypocalcaemia
• proximal myopathy

Question 13

Which groups are more at risk of developing osteomalacia?

Answer 13

• elderly housebound individuals
• covered muslim women
• people with malabsorption

Question 14

What are looser zones?

Answer 14

spontaneous incomplete fractures