Osteomalacia

Last updated: Friday, 24, December, 2010
CausesAppropriate Tests

Many of these disorders present as rickets in the paediatric age group. Calcium, phosphate, albumin, ALP.

Bone biopsy (sometimes with double tetracycline labelling), if confirmation is required.

Vitamin D deficiency

Vitamin D (25-hydroxy).

Lack of sunlight exposure

Dietary deficiency

Malabsorption

Disordered vitamin D metabolism

Vitamin D (1,25-dihydroxy).

Chronic Renal failure

Anticonvulsant therapy

Vitamin D dependent rickets

Phosphate deficiency

Phosphate - serum, creatinine - serum .

Phosphate - urine, creatinine - urine, with calculation of fractional excretion of phosphate.

Dietary

Increased phosphate loss

  • Vitamin D resistant rickets
  • Fanconi syndrome

 


See under Renal tubular disorders

Drug induced, especially

Diphosphonates
Fluoride
Antacid abuse

Toxic

Bone biopsy with measurement of toxic metal; consult pathologist.

Aluminium

Aluminium.

Lead 

See Lead poisoning

Cadmium 

Cadmium.

See Heavy metals - urine

Mineralisation defects (inherited)

Hypophosphatasia 

ALP; amino acids (ethanolamine phosphate) - urine.

Osteopetrosis

Osteogenesis imperfecta  

Molecular genetics for diagnosis and family studies.