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Osteomalacia

Última revisão: 15 Aug 2025
Última atualização: 13 Mar 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • older age
  • vitamin D and calcium deficient diets
  • lack of sunlight exposure
  • fractures
  • malabsorption syndromes
  • diffuse bone pain and tenderness
  • proximal muscle weakness
  • family history of osteomalacia
  • waddling gait
Detalhes completos

Outros fatores diagnósticos

  • anticonvulsant therapy
  • steatorrhea
Detalhes completos

Fatores de risco

  • dietary calcium and vitamin D deficiency
  • limited sunlight exposure
  • chronic kidney disease
  • inherited disorders of vitamin D and bone metabolism
  • hypophosphatasia
  • anticonvulsant therapy
  • mesenchymal tumors
  • Fanconi syndrome
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • serum calcium level
  • serum 25-hydroxyvitamin D level
  • serum phosphate level
  • serum BUN and creatinine
  • intact PTH
  • serum alkaline phosphatase
  • 24-hour urinary calcium
Detalhes completos

Investigações a serem consideradas

  • bone x-rays
  • 24-hour urinary phosphate
  • dual-energy x-ray absorptiometry
  • iliac crest biopsy with double tetracycline labeling
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

vitamin D deficient

inherited or acquired disorders of phosphate wasting

Colaboradores

Autores

Bridget Sinnott, MD
Bridget Sinnott

Professor of Medicine

Medical College Georgia

Augusta

GA

Declarações

BS declares that she has no competing interests.

Agradecimentos

Dr Bridget Sinnott would like to gratefully acknowledge Dr Jelena Kravarusic, a previous contributor to this topic. JK declares that she has no competing interests.

Revisores

Udaya Kabadi, MD, FRCP(C), FACP, FACE

Director

Endocrinology

Department of Internal Medicine

VA Medical Center

University of Iowa

Iowa City

IA

Declarações

UK declares that he has no competing interests.

Stephan Scharla, MD

Department of Internal Medicine

Endocrinology & Diabetes

LMU University Munich

Munich

Germany

Declarações

None declared.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Holick MF, Brinkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911-1930.Texto completo  Resumo

Cystic Fibrosis Trust. European cystic fibrosis bone mineralisation guidelines. Feb 2011 [internet publication].Texto completo  Resumo

Munns CF, Shaw N, Kiely M, et al. Global consensus recommendations on prevention and management of nutritional rickets. 2016 Feb;101(2):394-415.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Osteomalacia images
  • Diagnósticos diferenciais

    • Osteoporosis
    • Paget disease
    Mais Diagnósticos diferenciais
  • Guías de práctica clínica

    • Global consensus recommendations on prevention and management of nutritional rickets
    • Dietary reference intakes for calcium and vitamin D
    Mais Guías de práctica clínica
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