The condition osteomalacia affects the bones, making them soft and weak. It occurs when the bones do not mineralize properly, meaning they do not receive enough calcium and phosphate to harden and strengthen. A person with osteomalacia may have bone pain, fractures, deformities, and muscle weakness. Unlike rickets, which is a similar condition that affects children, osteomalacia is more common in adults than in children. Vitamin D, an essential part of bone health, is lacking in osteomalacia. A bone biopsy, blood tests, and X-rays can be used to diagnose osteomalacia. In addition to taking medications or having surgery if necessary, osteomalacia can be treated by increasing vitamin D, calcium, and phosphate intake. You can prevent osteomalacia by getting enough sun exposure, eating a balanced diet, and avoiding factors that interfere with bone mineralization.
Deficits in vitamin D are the main cause of osteomalacia. Vitamin D is a nutrient that helps the body absorb calcium and phosphate from food and use them to build and maintain strong bones. As well as the skin, the diet can provide vitamin D. Vitamin D can be produced by the skin when exposed to sunlight, and it can be obtained from foods such as fatty fish, egg yolks, and fortified dairy products. There are, however, some people who may not get enough vitamin D from these sources, due to factors such as:
Wearing clothing that covers most of the skin or living in a place where sunlight is limited
Having dark skin, which reduces the skin's ability to produce vitamin D
Vitamin D or calcium deficiency in the diet
Celiac disease, kidney disease, or liver disease affect vitamin D absorption or metabolism
Medication that lowers vitamin D levels, such as anticonvulsants, antiretrovirals, or corticosteroids
Osteomalacia can also be caused by:
A diet lacking calcium or phosphate, which are also important for bone health
Infections that affect enzymes or hormones involved in bone mineralization, such as hypophosphatemic rickets and pseudovitamin D deficiency rickets
Fibrous dysplasia and oncogenic osteomalacia are tumors that interfere with bone mineralization
The symptoms of osteomalacia may vary based on the severity and duration of the condition. A common symptom is bone pain, which can occur anywhere in the body, but is usually felt in the lower back, hips, legs, ribs, or pelvis. Osteomalacia can cause dull, aching, or throbbing pain and worsen with movement, pressure, or weight-bearing. Other symptoms include:
Even minor trauma or stress can result in bone fractures
Deformities caused by bending or bowing of the bones, especially in the legs, spine, or chest
An inability to walk, stand, or perform daily tasks due to muscle weakness
As a result of compression or collapse of the vertebrae in the spine, the height is reduced
Soft bones can compress or irritate nerves, resulting in numbness or tingling
The diagnosis of osteomalacia is based on the medical history, physical examination, laboratory and imaging tests. In addition to asking about the symptoms, onset and duration of the symptoms, medical history, and family history, the doctor will also conduct a physical examination that includes:
Examining the body for signs of bone pain, fractures, and deformities
Checking for tenderness or swelling in the bones and joints
Muscle strength and reflexes are tested
The patient's height and weight should be measured
Some laboratory and imaging tests may also be ordered by the doctor, including:
Measures the levels of vitamin D, calcium, phosphate, alkaline phosphatase, and parathyroid hormone in the blood and indicates bone health and mineralization.
In urine tests, calcium levels and phosphate levels are measured, as well as kidney function and bone turnover.
An X-ray can reveal the structure of the bones and the location of fractures or deformities
Using a bone density scan, you can determine your bone mineral density and fracture risk
A bone biopsy can be performed to take a small sample of bone tissue and examine it under a microscope to confirm the diagnosis and cause of osteomalacia
The treatment of osteomalacia depends on the cause and the severity of the condition, as well as the overall health and preference of the patient. In addition to correcting vitamin D deficiency, the treatment also improves bone mineralization and strength.
Oral or injectable vitamin D supplements can increase vitamin D levels in the body and improve calcium and phosphate absorption by the bones
Oral and injectable calcium and phosphate supplements can provide essential minerals for bone health and mineralization
The treatment of underlying conditions that cause or contribute to osteomalacia, such as kidney disease, liver disease, or tumors
A surgical procedure can repair or stabilize fractures, correct deformities, or remove tumors that interfere with bone mineralization.
Osteomalacia complications can be prevented or reduced with physical therapy, which can help improve mobility, posture, and muscle strength
Some measures can be taken to reduce the risk or severity of osteomalacia, including:
Get enough sunlight exposure by spending 15 minutes a day outdoors, preferably between 10 a.m. and 3 p.m., and exposing the arms, legs, or face to the sun
It's important to eat a balanced diet that is rich in vitamin D, calcium, and phosphate, as well as foods such as fatty fish, egg yolks, fortified dairy products, green leafy vegetables, and nuts
Follow the doctor's advice regarding dosage and duration when taking vitamin D supplements, particularly if the diet is inadequate or sunlight exposure is limited
Alcohol, smoking, and certain medications can interfere with vitamin D absorption or metabolism
Having your blood levels of vitamin D, calcium, phosphate, and other bone markers checked regularly and reporting abnormal results to your doctor
