| Subject | Contents |
| Definition | Osteomalacia involves softening of the bones caused by a deficiency of vitamin D or problems with the metabolism of this vitamin.
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| Causes, incidence, and risk factors | There are numerous causes of osteomalacia. In children, the condition is called rickets and is usually caused by a deficiency of vitamin D . Conditions that may lead to osteomalacia include inadequate dietary intake of vitamin D, inadequate exposure to sunlight (ultraviolet radiation), which produces vitamin D in the body and malabsorption of vitamin D by the intestines. Other conditions that can cause osteomalacia include hereditary or acquired disorders of vitamin D metabolism ; kidney failure and acidosis ; phosphate depletion associated with low dietary intake of phosphates; kidney disease or cancer (rare), and side effects of medications used to treat seizures . Risk factors are related to the causes. In the elderly, there is an increased risk amongst those who tend to remain indoors and who avoid milk because of lactose intolerance . Use of very strong sunscreen, limited exposure of the body to sunlight, short days of sunlight, and smog are factors that decrease formation of vitamin D within the body. |
| Symptoms | Diffuse bone pain , especially in the hipsMuscle weakness Bone fractures with minimal trauma Symptoms associated with low calcium including: Numbness around the mouth Numbness of extremities Spasms of hands or feet Abnormal heart rhythms |
| Signs and tests | A bone biopsy shows osteomalacia. Serum vitamin D level may be low.Serum calcium levels vary with the cause of the disorder. Serum phosphate levels vary with the cause of the disorder. A bone X-ray may show features of osteomalacia. a bone mineral density scan (DEXA) may show reduced bone mineral density Other tests may be done to determine renal problems or other underlying disorders. They include:PTHCalcium (ionized)ALP (alkaline phosphatase) isoenzyme |
| Treatment | Oral supplements of vitamin D , calcium and phosphorus may be given depending on the underlying cause of the disorder. Larger doses of vitamin D and calcium may be needed for people with intestinal malabsorption . Monitoring of blood levels of phosphorus and calcium may be indicated for people with certain underlying conditions. |
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| Expectations (prognosis) | Improvement in the condition of the bones, evidenced by bone X-rays , can be seen within a few weeks in some people with vitamin deficiency disorders. Complete healing with treatment takes place in 6 months. |
| Complications | Recurrence of symptoms is a possible complication. |
| Calling your health care provider | Call for an appointment with your health care provider if you have symptoms of osteomalacia, or if you think that you may be at risk for this disorder. |
| Prevention | An adequate dietary intake of dairy products that are fortified with vitamin D and exposure of the body to sunlight can prevent osteomalacia caused by vitamin D deficiency in adults. |
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