Osteomalacia

Overview

What is osteomalacia?

Osteomalacia means "soft bones." Osteomalacia is a disease that weakens bones and can cause them to break more easily. It is a disorder of decreased mineralization, which results in bone breaking down faster than it can re-form. It is a condition that occurs in adults. In children, inadequate concentrations of vitamin D may cause rickets.

Symptoms and Causes

What causes osteomalacia?

Osteomalacia develops most commonly due to a vitamin D deficiency (often from not getting enough sunlight), or less frequently, due to a digestive or kidney disorder. Vitamin D is essential for calcium absorption and for maintaining bone health. These disorders can interfere with the body's ability to absorb vitamins. There are also rare genetic conditions that can cause osteomalacia.

What are the symptoms of osteomalacia?

The most common symptoms of osteomalacia are pain in the bones and hips, bone fractures, and muscle weakness. Patients can also have difficulty walking.

Diagnosis and Tests

How is osteomalacia diagnosed?

There are various tests that can be performed to determine if someone has osteomalacia.

  • The most important indicator is low levels of vitamin D, but low levels of calcium or a significant drop in phosphate levels may also indicate osteomalacia.
  • X-rays may be taken to see if there is any evidence of osteomalacia.
  • A bone mineral density scan may be helpful in evaluating the amount of calcium and other minerals present in a patient’s bone segment. These scans are not required to make the diagnosis of osteomalacia. However, they may give important information about a patient’s bone health.

Rarely, the doctor may perform a bone biopsy, in which a sample of bone tissue is taken and examined.

Management and Treatment

How is osteomalacia treated?

Patients who have osteomalacia can take vitamin D, calcium or phosphate supplements, depending on the individual case. For instance, people with intestinal malabsorption (the intestines cannot absorb nutrients or vitamins properly) may need to take larger quantities of vitamin D and calcium.

Other treatments to relieve or correct osteomalacia symptoms may include:

  • Wearing braces to reduce or prevent bone irregularities
  • Surgery to correct bone deformities (in severe cases)
  • Adequate exposure to sunlight

Last reviewed by a Cleveland Clinic medical professional on 08/14/2018.

References

  • Lorenzo JA, Canalis E, Raisz LG. Metabolic bone disease. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 29.
  • Bhan A, Rao AD, Rao DS. Osteomalacia as a Result of Vitamin D Deficiency. Endocrinol Metab Clin North Am. 2010;39(2):321.
  • Office of Dietary Supplements - National Institutes of Health. Retrieved August 4, 2012. Accessed 10/3/2018.Dietary Supplement Fact Sheet: Vitamin D. (2011, June 24). (https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/)
  • Lee, JY, So, Tsz-Yin, Thackray, J. A Review of Vitamin D Deficiency. J Pediatr Pharmacol Ther 2013 Oct-Dec; 18(4): 277–291.

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