Osteomalacia

Keywords: Rickets

Causes

Appropriate Tests

 

Many of these disorders present as rickets in the paediatric age group. Calcium, Phosphate, Albumin, Alkaline phosphatase.

Bone biopsy (sometimes with double tetracycline labelling), if confirmation is required.

Vitamin D deficiency

Vitamin D (25-hydroxy).

Lack of sunlight exposure

 

Dietary deficiency

 

Malabsorption

 

Disordered vitamin D metabolism

Vitamin D 1,25-dihydroxy

Chronic renal failure

 

Anticonvulsant therapy

 

Vitamin D dependent rickets

 

Phosphate deficiency

Phosphate, Creatinine.

Phosphate urine, Creatinine urine, with calculation of fractional excretion of phosphate.

Dietary

 

Increased phosphate loss

  • Vitamin D resistant rickets
  • Fanconi syndrome

 


See under Renal tubular disorders

Drug induced, especially

Bisphosphonates
Fluoride
Antacid abuse

 

Toxic

Bone biopsy with measurement of toxic metal; consult pathologist.

Aluminium

 

Lead

See Lead poisoning

Cadmium

See Heavy metals urine

Mineralisation defects (inherited)

 

Hypophosphatasia

Alkaline phosphatase, Amino acids urine (ethanolamine phosphate).

Osteopetrosis

 

Osteogenesis imperfecta

Molecular genetics for diagnosis and family studies.