Abstract
Osteomalacia is a bone mineralisation defect in mature bone. The most common cause is a severe vitamin D deficiency, which in our environment occurs in situations of social exclusion or malabsorption. It is generally clinically asymptomatic, but there can be bone pain and muscle weakness. Tetany is observed in cases with severe hypocalcaemia. In very evolved forms, x-ray shows biconcave vertebrae or deformity of the long bones with Looser's pseudofractures. When there is a vitamin D deficiency, serum levels of 25(OH)2D, calcium, phosphorus descend, while alkaline phosphatase and PTH levels rise. Diagnosis is confirmed by bone histomorphometry. It is important to treat the cause of osteomalacia, if possible. A vitamin D deficiency is corrected by ensuring adequate intake of calcium. Occasionally very high doses of vitamin D will be required.
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