What is Osteomalacia?
Osteomalacia is a weakening of the bones. Problems with bone formation or the bone-building process causes osteomalacia. This condition isn’t the same as osteoporosis. Osteoporosis is a weakening of living bone that is already formed and being remodelled.
What are the causes of osteomalacia?
A lack of vitamin D is the most common cause of osteomalacia. Vitamin D is an important nutrient that helps you absorb calcium in your stomach.Vitamin D also helps maintain calcium and phosphate levels so your bones form properly. It’s made within the skin from exposure to ultraviolet (UV) rays in sunlight. It can also be absorbed from foods like dairy products and fish. Your body can’t process the calcium your bones need to stay strong if you have low levels of vitamin D. This can result from a problem with diet, a lack of sun exposure, or an issue with your intestines.
You may also have a problem absorbing vitamin D or breaking down food to release it if you’ve had surgery to remove parts of your stomach or small intestine.
Certain conditions can interfere with the absorption of vitamin D:
Celiac disease can damage the lining of your intestines and prevent the absorption of key nutrients like vitamin D.
Certain types of cancer can interfere with vitamin D processing.
Kidney and liver disorders can affect the metabolism of vitamin D.
A diet that doesn’t include phosphates can cause phosphate depletion, which can also lead to osteomalacia. And drugs to treat seizures — like phenytoin and phenobarbital — can also result in osteomalacia.
What are the symptoms of osteomalacia?
The most common is bones that fracture easily. Another is muscle weakness. This happens because of problems in the areas where muscle attaches to bone. A person with osteomalacia may have a hard time walking or develop a waddling gait.
Bone pain, especially in your hips, is also a common symptom. A dull, aching pain can spread from your hips to the following places: lower back,pelvis,legs,ribs
If you also have very low levels of calcium in your blood, you may have:
- irregular heart rhythms
- numbness around your mouth
- numbness in your arms and legs
- spasms in your hands and feet.
How to Diagnose
- blood tests to measure levels of calcium, phosphate, and vitamin D
- kidney function and urine tests
- X-rays – images of the leg bones to look for abnormalities such as pseudofractures (lines that look like fractures on the X-ray but aren’t actual fractures); X-rays of other bones such as the pelvis may also show changes in shape
- CT (computed tomography) scans of the spine to show changes in the vertebrae
a bone biopsy – a needle is inserted into the bone to allow the doctor to remove a small piece of bone tissue for analysis
If a lack of vitamin D is causing osteomalacia, the patient will be advised to increase their vitamin D intake. Some foods rich in vitamin D are:
- enriched or fortified milk and milk products
- herring, salmon, shrimp, sardines
- fortified cereal
- cod liver oil
- egg yolks
Women who are feeding their babies only breast milk should ask their doctor if vitamin D supplements are necessary.
People with osteomalacia may be advised to get exposure to the sun but should be careful to avoid getting sunburned. It is better to stay in the sun for short periods (10 to 15 minutes) each day rather than for longer periods less frequently. This strategy decreases the chance of skin damage from the sun.
Some people may require braces to help realign the affected bones. Surgery may be necessary to realign severely deformed bones.
With successful treatment, osteomalacia can be eliminated and its effects completely healed within a modest period of time (usually several months).
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