Osteomalacia

Osteomalacia is a condition in which the bones are softened due to vitamin D deficiency. This condition happens due to improper mineralizations of the bone matrix. Disorders of vitamin D metabolism and lack of its absorption plays a significant role in resulting osteomalacia.

Clinical manifestations of osteomalacia include skeletal deformities which are identified post fractures. Bone density is reduced to a larger extent which is associated with the loss of trabeculae and thinning of cortices. Significant X- ray determination includes radiolucent bands referring to pseudo fractures perpendicular to the femur, pelvis and scapula. Muscle weakness and achy bones are also associated with osteomalacia. The level of serum calcium and phosphorus is altered depending upon the cause of the disease. Osteomalacia in turn causes secondary hyperparathyroidism.

The symptoms of osteomalacia include loss of muscle density and strength, sharp pain or achy bones , gait and decreased physical activity. These symptoms are often noticed in the regions of hip, arms, legs, lower back and also ribs. Although osteomalacia is associated with vitamin D absorption disorder in the body, there are other conditions such as gastrectomy, celiac disorders which play a major role in the disease progression. The predominant reason for osteomalacia among patients who have undergone gastrectomy or having autoimmune disorders of the small intestine is due to the impairment of vitamin D absorption in these parts of the body. Other than these causes, osteomalacia can also be associated with drugs such as phenobarbital.

Since osteomalacia is associated with vitamin D deficiency, the treatment includes oral administration of ergocalciferol 50,000 international units for a period of eight weeks. This treatment is followed by continuous intake of 800 IU of vitamin D associated with maintenance therapy. Osteomalacia caused due to malabsorption requires higher doses of ergocalciferol ranging from 100,000 IU biannually. The intake of vitamin D should be supported by calcium supplementation. Subsequently in order to monitor the progress of prophylaxis, the serum and urinary calcium levels are monitored. The normal value for the 24 hour urinary calcium is 100-250mg/24hr.

Phosphorus

Healthy bones and teeth are formed by phosphorus. Phosphorus is vital to body metabolism. Phosphorus is found in dairy foods, meat and fish. Phosphorus deficiency can result in rickets in children and osteomalacia in adults. Imbalance in phosphorus and calcium can lead to osteoporosis.