Osteomalacia

 

Symptoms:

1. Muscle aches
2. Proximal muscle weakness
3. General fatigue
4. Bone pain

Laboratory Findings:

1. Elevated alkaline phosphatase (ALP)
2. Low calcium
3. Low phosphate

Risk Factors:
i. Lack of sun exposure
ii. Poor dietary intake of vitamin D
iii. Sedentary lifestyle

Diagnosis:

Laboratory Tests:

i. Elevated ALP
ii. Low serum calcium and phosphate
iii. Low vitamin D levels

Imaging:

X-rays may show Looser’s zones (pseudofractures).

Bone Biopsy:
Confirmatory in uncertain cases, showing unmineralized osteoid.

Management:

i.Vitamin D Supplementation:
. High-dose vitamin D therapy (cholecalciferol or ergocalciferol).
. Maintenance doses of vitamin D once levels are corrected.

ii.Calcium Supplementation:
. To ensure adequate calcium intake and improve bone mineralization.

iii. Addressing Underlying Causes
iv. Encouraging safe sun exposure.
v. Improving dietary intake of vitamin D and calcium.

 

Differential Diagnosis Based on Laboratory Findings

 

Calcium (Ca) Levels	Phosphate (PO4) Levels	Alkaline Phosphatase (ALP) Levels	Likely Diagnosis
Normal	Normal	Normal	Osteoporosis
Normal	Normal	High	Paget’s Disease
Low	Low	High	Osteomalacia