Severe skeletal disability and abnormal biochemical tests & disease review

Abstract

Musculoskeletal pain is the most common disorder encountered in our clinical practice that afflicts all individuals around the world and has not exempted gender, ethnicity, color, or age. The tissues which are affected are muscles, ligaments, tendons, cartilages, and bones. It can be caused by a wide range of etiologies. Chronic musculoskeletal pain causes significant morbidity and is associated with varying degrees of physical and emotional disabilities. Vitamin D deficiency has been given a major concern in the last 3 decades and has been linked with special predilection for some ethnic groups, geographical regions, high-risk groups from extreme age, social and religious customs, and most importantly sun exposure and lack of intake. We received this patient which was a young woman with good socioeconomic status and a sunny climate around the year. The patient had been referred from the Orthopedics department (late December 2013) to the Endocrine and Diabetes Clinic as having g skeletal disability and chronic pain with abnormal laboratory tests, that had eventually demonstrated secondary hyperparathyroidism with modest hypocalcemia. Clinical work-up had demonstrated hypovitaminosis D and with a musculoskeletal disorder; Osteomalacia, but the precise etiology could not be detected and some of the causes remained speculative!