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


Laboratory Tests:

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


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

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


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) LevelsPhosphate (PO4) LevelsAlkaline Phosphatase (ALP) LevelsLikely Diagnosis
NormalNormalHighPaget’s Disease

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