Osteomalacia

Vitamin D deficiency is the most common cause of osteomalacia.

Patients frequently complain of diffuse bony pain with a history of limited sunlight exposure.

Proximal muscle weakness, spinal tenderness to percussion, pseudofractures, and skeletal deformities are found commonly.

Diagnosis is made via laboratory results with a low vitamin D level in the setting of low or normal calcium and an elevated intact parathyroid hormone (PTH) level.

Once the underlying cause is addressed, a successful treatment regimen is possible: increased sunlight exposure, oral vitamin D, and calcium replacement.

Osteomalacia is a metabolic bone disease characterised by incomplete mineralisation of the underlying mature organic bone matrix (osteoid) following growth plate closure in adults.

In contrast, rickets is a metabolic bone disease characterised by defective mineralisation of the epiphyseal growth plate cartilage in children, resulting in skeletal deformities and growth retardation. Rickets and osteomalacia are different manifestations of the same underlying pathological process.