Posted by e-Medical PPT Saturday, November 6, 2010
Osteomalacia is the softening of the bones in adults due to defective bone mineralization.
The causes of adult osteomalacia are varied, but ultimately result in a vitamin D deficiency:
    * Insufficient sunlight exposure, especially in dark-skinned subjects
    * Insufficient nutritional quantities or faulty metabolism of vitamin D or phosphorus
    * Renal tubular acidosis
    * Malnutrition during pregnancy
    * Malabsorption syndrome
    * Chronic renal failure
    * Tumor-induced osteomalacia
    * Long-term anticonvulsant therapy
    * Coeliac disease
Osteomalacia in adults starts insidiously as aches and pains in the lumbar region and thighs, spreading later to the arms and ribs. The pain is symmetrical, non-radiating and is accompanied by sensitivity in the involved bones. Proximal muscles are weak, and there is difficulty in climbing up stairs and getting up from a squatting position.Due to demineralization bones become less rigid. Physical signs include deformities like triradiate pelvis and lordosis. The patient has a typical "waddling" gait. Pathologic fractures due to weight bearing may develop.
Nutritional osteomalacia responds well to administration of 10,000 IU weekly of vitamin D for four to six weeks. Osteomalacia due to malabsorption may require treatment by injection or daily oral dosing of significant amounts of vitamin D.

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