Osteomalacia and Rickets


Osteomalacia and Rickets

Vitamin D deficiency causes rickets in children and osteomalacia in adults.

The body needs 710 micrograms of vitamin D per day to maintain healthy bones.

People who do not get out or for cultural or religious reasons are completely shielded from the sun by their clothing.

Risk factors

Vitamin D deficiency. (Lack of exposure to sunlight  for example)

Coeliac disease

Chronic renal failure

Gastric bypass surgery

Medications such as phenytoin

Clinical features of rickets

  • Bone pain/tenderness: arms, legs, spine, pelvis
  • Skeletal deformity: bow-legs, pigeon chest (forward projection of the sternum), rachitic rosary (enlarged ends of ribs), asymmetrical/ odd-shaped skull due to soft skull bones, spinal deformity (kyphosis, scoliosis), pelvic deformities
  • Pathological fracture
  • Dental deformities—delayed formation of teeth, holes in the enamel,
  • Muscular problems—progressive weakness, d muscle tone, muscle cramps
  • Impaired growth l short stature (can be permanent


Clinical features of osteomalacia


  • Bone pain—diffuse, particularly in hips
  • Muscle weakness
  • Pathological fractures
  • Low calcium Increased perioral numbness, numbness of extremities, hand, and feet spasms, and /or arrhythmias


Low serum and urinary calcium

Low serum phosphate

Elevated serum alkaline phosphatase.

Low vitamin D


Treat the underlying cause

Calcium and vitamin D supplements

Surgical correction of skeletal deformities




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