| ID | 162 |
|---|---|
| Name | OSTEOMALACIA |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | Investigations: 1. Radiological examination- shows rarefaction of bone and commonly translucent bands. Common sites are the ribs, the axillary border of scapula, the pubic rami etc. 2. Histological examination- Bone biopsy shows the presence of excess osteoid tissue. |
| Management | |
| Introduction | It means softening of bone, is primarily due to a deficiency of vitamin D, and to a lesser extent of calcium, or both. |
| History | |
| Etiology | Etiology: 1. Due to malabsorption from any cause e.g. partial gastrectomy. 2. Due to direct dietary deficiency of vitamin-D. 3. Chronic renal disorders. 4. Prolonged lactation and frequent pregnancy. 5. Lack of sun-light. |
| Clinical Features | Clinical features: 1. Skeletal pain is usually present and persistent and ranges from backache to severe pain. 2. Bone tenderness on pressure is common. 3. Muscular weakness is often present. 4. A wadling gait is not unusual. 5. Tetany may be present. 6. Spontaneous fracture may occur. |
| Preventions | |
| Treatment | Treatment: 1. Vitamin-D therapy: When osteomalacia is primarily due to defective intake, a therapeutic dose of ergocalciferol (D2) 250-l000ng or cholecalciferl (D3) 25-125ug (1000-5000 i.u.) daily. Clinical improvement can be shown by an elevation of serum 25 (OH)D and a reduction in parathyroid hormone (PTH). With vitamin-D treatment, serum alkaline phosphatase sometimes rises initially as bone mineralisation increases, later on it falls to within normal range. After 3-4 months, treatment can be stopped or reduced to the prophylactic dose of cholecalciferol (D3) 10-20ug daily. If there is evidence of malabsorption the dose should be increased and to be given intramuscularly. If the disease is secondary to renal disorders double or triple this dose may be necessary or alfa calcidol should be used. 2. A good diet should be given which includes milk. 3. A supplement of calcium should be given orally. 4. Treatment of under lying cause. |
| Complications | |
| Prognosis | |
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