Neurology
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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
Investigation
Low serum and urinary calcium
Low serum phosphate
Elevated serum alkaline phosphatase.
Low vitamin D
Management
Treat the underlying cause
Calcium and vitamin D supplements
Surgical correction of skeletal deformities
LOOSER NODES /PSEUDOFRACTURE
