Osteomalacia and rickets
Osteomalacia is a skeletal mineralisation disorder. The bones are soft and this causes deformation and fractures, even without trauma, especially affecting the pelvis, ribs, and spinal column. In addition, it can cause pain, especially in the spinal column, pelvis, legs, and ribs, as well as weakness in the legs. In childhood, this disorder is called rickets and it can also negatively affect growth.
Causes
In order to correctly mineralise, bones need calcium and phosphate. The absorption of these substances (especially calcium) depends on vitamin D, which is synthesized in the skin using UVB rays from the sun. Thus, osteomalacia is caused by a severe deficiency in vitamin D and/or phosphate.
The main causes of a severe vitamin D deficiency are varied and include:
- Lack of sunlight.
- Disease processes or pathologies in which there is a problem with absorbing nutrients (surgeries that have removed intestine or the stomach, partially or fully, celiac disease, inflammatory intestinal diseases, etc.).
- Liver and kidney diseases.
Another, more infrequent cause is phosphate deficiency, either congenital (such as X-linked hypophosphataemic rickets or fibrous dysplasia) or acquired (Fanconi syndrome, tumours, IV iron administration, antiretroviral therapy, etc.).
Diagnosis
The diagnosis will be performed based on the symptoms, blood analysis, urinalysis, and X-rays.
Treatment
Treatment consists of correcting the vitamin D and calcium deficiencies and also treating the causes underlying these.
