OSTEOMALACIA

DEFINITION

Osteomalacia is a metabolic bone disease characterized by inadequate mineralization of bone. As a result of faulty
mineralization, there is softening and weakening of the skeleton, causing pain, tenderness to touch, bowing of the bones, and
pathologic fractures.

CAUSES

 Conditions that interfere with the body's absorption of vitamin D, such as intestinal disorders
(including Crohn's disease and celiac disease)
 Gastrointestinal disorders (eg, celiac disease, chronic biliary tract obstruction, chronic pancreatitis, small bowel resection) in
which fats are inadequately absorbed are likely to produce osteomalacia through loss of vitamin D (along with other fat soluble
vitamins) and calcium
 Lack of vitamin D in the diet
 Not enough exposure to sunshine - this commonly affects people who are confined indoors for prolonged periods of time
because of age, disability, or illness
 Having dark skin, which interferes with the effects of sunlight on vitamin D
 Certain medications, including some medications prescribed for epilepsy(eg, phenytoin, phenobarbital)
 Very rare tumours
 Hyperparathyroidism leads to skeletal decalcification

PATHOPHYSIOLOGY

Deficiency of activated vitamin D (calcitriol)

(which promotes calcium absorption from the gastrointestinal tract and facilitates mineralization of bone)

The supply of calcium and phosphate in the extracellular fluid (blood) is Low

Without adequate vitamin D, calcium and phosphate are not moved o calcification sites in bones.

Failed calcium absorption Excessive loss of calcium from the body

(eg, malabsorption syndrome) Gastrointestinal disorders (chronic biliary tract obstruction,
chronic pancreatitis, small bowel resection)

Fats are inadequately absorbed

Loss of vitamin D (along with other fat soluble vitamins) and calcium