Osteomalacia (Subscribe)  

Hypophosphatemic osteomalacia with plantar neurilemoma. A review of the literature (100 cases).
Crouzet, J : Mimoune, H : Beraneck, L : Juan, L H
Rev-Rhum-Engl-Ed. 1995 Jun; 62(6): 463-6
Abstract
A case of hypophosphatemic osteomalacia with recovery after removal of a plantar neurilemoma is reported. One hundred cases of osteomalacia with a connective...

Radiology case 471-571 26 year old lady with bone pain, immigrant originally from India.
The posterior borders of 2nd and 3rd ribs, on both sides, show almost symmetrical low density lines crossing the each rib with sclerotic margins. These areas mark regions of mechanical stress, which is related to neighbouring attachments...

- is a type of metabolic bone disease in which the essential problem is a lack of available calcium or phosphorus (or both) for mineralization of newly formed osteoid; - children w/ rickets & adults w/ osteomalacia...

Osteomalacia is characterized by incomplete mineralization of normal osteoid tissue following closure of the growth plates. Osteomalacia may be part of the spectrum of osseous abnormalities that can be observed in patients with chronic renal insufficiency. This condition is referred to as renal osteodystrophy.

insufficient mineralization of osteoid
etiology:
* dietary deficiency of vitamin D3, lack of solar irradiation
* deficiency of metabolism of vitamin D
o chronic renal tubular disease
o phenobarbitol, diphenylhydantoin
* decreased absorption of vitamin...

"A condition marked by softening of the bones (due to impaired mineralization, with excess accumulation of osteoid), with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium. (Dorland, 27th ed)" Source: Medical Subject Headings, 2007_2006_08_08 "inadequate or delayed mineralization of osteoid in mature cortical...

Radiology case 448-571 Clinical presentation: 29 year old female, from India, vegitarian. Back and hip pain, muscle weakness.
The are symmetrical linear defects in the superior rami of the pubis. The ischio-pubic synostoses are low density, widened and the bones are not aligned (in a 29 year old whose bones should be...

lucent band of decreased cortical density
* perpendicular to bone surface
* often multiple, +/- symmetrical
* +/- callus formation
* "pathognomonic" of osteomalacia
o seen on compressive (concave) side (eg, prox femur)
* also seen in Paget dz on tensile (convex) side

Lack of Vitamin D will reveal itself in those areas in the bone that show the greatest activity. Growth processes in the immature skeleton cause Rickets and structural responses to stress in the mature skeleton give rise to Osteomalacia. In the immature skeleton, the greatest activity is the ossification boundary...

Definition
Deficiency of calcium and/ or phosphate which results in inadequate osteoid mineralization
  * Less mineralized bone per volume of bone
  * Increased uncalcified osteoid
Rickets - immature skeleton
Osteomalacia - mature skeleton
Bone formation is slowed & unmineralized osteoid accumulates along new bone surfaces
Remember that osteoid is the organic component of woven bone...

Objectives
1. Outline the pathway of Vitamin D metabolism
2. Define: osteomalacia, rickets
3. Describe the clinical features of rickets
4. Describe the radiographic findings noted in patients with rickets, and their relationship with histologic findings
5. List causes of...

Osteomalacia means "soft bones". The bones are about half mineral (calcium and phosphate) and half protein matrix, which is called osteoid. Normally 98% of the osteoid is mineralized, and 2% is new osteoid that has just been made and is waiting to get mineralized. In osteomalacia, the mineral does not...