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.
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 |