Osteomalacia (Soft Bones)

Osteomalacia means softening of the bones. When there is deficient calcium incorporation into the skeleton, the bones become flexible and gradually deformities can result. Osteomalacia in children is termed rickets.

Osteomalacia may occur if there is not enough vitamin D and calcium in the diet or as a result of digestive disorders. This results in poor absorption of vitamin D, which is usually absorbed with fat. There is also a hereditary form of rickets with shortened adult stature, often called vitamin D-resistant rickets. Kidney abnormalities can also cause osteomalacia.

Signs and symptoms in adults
You may experience pain in the bones of the arms, legs, spine, and pelvis, with tenderness of the bones. With severe prolonged cases there can be progressive weakness.

Generally in developed countries, dietary Osteomalacia is rare, and is more likely to be found in South Asians. This may be due to a lack of calcium in the diet or exposure to sunlight. A long-term deficiency of calcium in the diet also can result in osteomalacia.

Diagnosis
If you are suspected of a diagnosis of osteomalacia or rickets after a clinical examination, a blood test is done to measure the amounts of the minerals calcium and phosphorus, and vitamin D measurement. X-rays of the affected bones are also obtained. On rare occassions, a bone biopsy, in which a small sample of bone tissue is removed for analysis may also be needed to confirm the diagnosis.

Once osteomalacia is diagnosed, the underlying cause has to be established.

Treatment
Treatment is usually directed toward correcting the underlying problem. Calcium and vitamin D supplements may be necessary. In extreme cases, particularly in vitamin D-resistant rickets, skeletal deformities may require surgical correction.

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