Osteomalacia diagnosis - soft bones - adults - vitamin D deficiency

Osteomalacia > Causes > Symptoms > Diagnosis > Treatment > Prevention > Rickets (in children )

The diagnosis of osteomalacia is by visual observations, laboratory tests, radiography and biopsy.

Diagnosis of osteomalacia by visual observation

Osteomalacia starts as pain in the lower back and thighs and spreads to legs, arms and ribs.

The affected person appears weak and has difficulty even in walking.

He may have waddling gait. He may have 'swayback' appearance.

He may complain of pain all over the body and especially in bones. The pain increases in shocks and on pressure.

He has pain in the back, hips and the long bones. He complains of muscle weakness.

He may have fractures with out any fall or known reason.

Young adults may show slight bowing of long bones.

The patient may have tetany, spasms, numbness in the limbs and abnormal heart beats.

All these observed signs help in the diagnosis of osteomalacia.

Laboratory procedures for diagnosis of osteomalacia

The serum calcium is lower than the required level (hypocalcemia).

Phosphorus serum levels will be low (hypophosphatemia).

Serum alkaline phosphate and PTH (parathyroid hormone) will be elevated than the normal level.

Serum levels of 25-hydroxyvitamin D will be low.

Urine calcium will be low.

Urine 1,25-dihydroxyvitamin D levels will be low.

Radiography procedures for diagnosis of osteomalacia

Radiography of the affected skeletal areas show deformity.

Partial fractures are seen on the bones.

Radiographs of the affected bones show pseudofractures (Loser's zones or Milkman syndrome).

Protrusio acetabuli (the socket protruding into pelvis) condition may appear restricting the movement of hip joint.

Radiography further shows osteopenia of bones wherein the mineral density is lower than the normal.

Vertebral compression fractures may be present.

Biopsy for diagnosis of osteomalacia

Biopsy of the bones shows increased osteoid and lowered calcifying mineral.

Once the ailment shows up as osteomalacia in the diagnosis the patient is given all the treatments required with an effort to bring him back to normalcy.

Osteomalacia symptoms - soft bones - adults - vitamin D deficiency

Osteomalacia > Causes > Symptoms > Diagnosis > Treatment > Prevention > Rickets (in children)

Common signs and symptoms of osteomalacia are bone pain, muscle pain and easy fractures of bones in the adults.

Osteomalacia affected patient shows signs and symptoms like widespread pain in the bones

The signs and symptoms of osteomalacia may not be confused with arthritis pain which is the inflammation of the joints and the resultant pain.

The signs and symptoms are specific. Osteomalacia caused pain emanates from the skeletal tissue. This pain is of permanent character deep and nagging.

The pain emantes from back, hips, ribs and long bones. Pain is also caused by minor cracks (partial fractures) in the bones.

Osteomalacia affected person shows signs and symptoms of weak muscles

With the pain in the bones the patients mobility decreases and the patient may also show signs of myalgia (muscle pain).

Low levels of calcium and phosphorus along with low levels of vitamin D affect mucle functions.

With reduced activity the muscle mass may decrease and muscle atrophy may set in. There can be partial or complete wasting away of the muscles.

Muscle weakness especially of the upper arms and thighs, decreases the quality of life and the sufferer experiences great difficulty in performing simple tasks like getting up from a chair or climbing a flight of stairs.

Osteomalacia affected person shows symptoms like fractures on trivial causes

Pathologic fractures may occur in osteomalacia affected person. The fractures occur during the normal routine activities. The reason for this is that the bones have so badly demineralised that they are not able to perform normal routine functions.

Deformities in osteomalacia

The affected person may suffer from lordosis a deformed condition of the vertibrae. There is curvature of the vertibral column in lower back giving 'swayback' appearance to the person. Deformaties of the pelvis also occur in osteomalacia.

The gait of the patient is affected and he shows typical symptoms of waddling gait (myopathic gait). The waddling is due to deformity of the pelvic girdle and also due to proximal muscles getting weak.

The osteomalacia patient sometimes may experience tetany. Uncontrolled muscle spasm and seizures are due to low serum levels of calcium.

Causes of osteomalacia - soft bones - adults - vitamin D deficiency

Osteomalacia > Causes > Symptoms > Diagnosis > Treatment > Prevention > Rickets (in children)

Among the many factors, severe vitamin D deficiency causes osteomalacia resulting in soft bones by their hypomineralisation in adults.

Adult bones after attaining growth, due to many factors connected with vitamin D deficiency, lose the calcium and phosphorus in them during bones turnover and become soft. The causes of osteomalacia are numerous.

Insufficient exposure to sunlight is one of the prime causes of osteomalacia (soft bones)

People living in higher latitudes face shorter days, especially in winter. They are also compelled to be home bound due to adverse weather conditions.

In darker skinned people the problem is compounded due to their reduced vitamin D synthesis ability. This is due to high melanin pigment deposits in their skin which cut off UV-B rays from reaching the vitamin D producing region of the skin and result in osteomalacia (soft bones).

Deficiency of vitamin D in diet is one of the causes of osteomalacia

The plant sources of vitamin D are very limited. Animal fats especially fish oils and fats are rich in vit D. Eggs and animal liver also contains vit D. Fortified milk and fortified cereal flours also can be good sources. Vegans who do even drink milk are in the risk of getting osteomalacia and soft bones.

Economically weaker sections of the people are prone to get affected by both calcium and vit D deficiency. This causes osteomalacia and soft bones.

Living in places continuously affected by fog and smog causes osteomalacia

Residents of the cities continuously covered by fog and smog may be affected or get into presymptomatic stage of this ailment and soft bones.

Medicine used in the treatment of epilepsy and seizures causes osteomalacia

Epileptic seizures are prevented and controlled by phenobarbital and phenytoin. These drugs increase the hepatic metabolism. By this reaction the vitamin D is converted into inactive forms and the calcium absorption is affected leading to soft bones.

Orlistat (weight-loss drug) and cholestyramine (cholesterol-lowering drug) reduce absorption of fat soluble vitamins like vit D.

Corticosteroids like prednisone may decrease calcium absorption and causes osteomalacia by affecting cholecalciferol metabolism.

Malnutrition during pregnancy causes osteomalacia

Pregnant women transfer lots of vitamin D, calcium and phosphorus to the growing fetus. The vitamin D and calcium reserves in the pregnant woman's body are tapped to maintain uninterrupted supply to the growing fetus. If the supplies are not replenished by diet, supplements and sunlight exposure, osteomalacia and soft bones are caused.

Celiac disease causes osteomalacia

Celiac disease (coeliac disease) is a disorder of the small intestine which is autoimmune in nature with genetic predisposition. In this disease there is a reaction of the body to gluten protein present in wheat. There is inflammation of the small intestine and atrophy of the villi which are responsible for nutrient absorption. Hence there no nutrient absorption and along with many deficiency induced ailments, severe deficiency of vitamin D also occurs and causes osteomalacia and soft bones.

Certain types of cancers, hereditary disorders in the metabolism of vit D, renal diseases like renal tubular acidosis and disease of the liver can be the causes of osteomalacia and soft bones.