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Osteomalácia

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 8 Aug 2025
Última atualização: 13 Mar 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • idade avançada
  • dietas deficientes em vitamina D e cálcio
  • ausência de exposição à luz solar
  • fraturas
  • síndromes de má absorção
  • dor e sensibilidade óssea difusas
  • fraqueza muscular proximal
  • história familiar de osteomalácia
  • marcha cambaleante
Detalhes completos

Outros fatores diagnósticos

  • terapia com anticonvulsivante
  • esteatorreia
Detalhes completos

Fatores de risco

  • deficiência de cálcio e vitamina D na dieta
  • doença renal crônica
  • exposição solar limitada
  • distúrbios hereditários de vitamina D e metabolismo ósseo
  • hipofosfatasia
  • terapia com anticonvulsivante
  • tumores mesenquimais
  • síndrome de Fanconi
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • nível de cálcio sérico
  • nível sérico de 25-hidroxivitamina D
  • nível de fosfato sérico
  • ureia e creatinina séricas
  • paratormônio (PTH) intacto
  • fosfatase alcalina sérica
  • cálcio urinário de 24 horas
Detalhes completos

Investigações a serem consideradas

  • radiografia óssea
  • fosfato urinário de 24 horas
  • absorciometria por dupla emissão de raios X
  • biópsia da crista ilíaca com dupla marcação pela tetraciclina
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

deficiência de vitamina D

distúrbios hereditários ou adquiridos de perda de fosfato

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

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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.Full text  Abstract

Cystic Fibrosis Trust. European cystic fibrosis bone mineralisation guidelines. Feb 2011 [internet publication].Full text  Abstract

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

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Osteomalácia images

  • Differentials

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  • Guidelines

    • Vitamin D and bone health: a practical clinical guideline for patient management
    • Vitamin D and bone health: a practical clinical guideline for patient management
    More Guidelines
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