Osteomalacia - wikipedia Osteomalacia Osteomalacia Vitamin D deficiency most common cause of this medical condition Classification and external resources Specialty rheumatology ICD - 10 M83. 8 eMedicine 000376 / Osteomalacia Patient UK Osteomalacia ( edit on Wikidata ) Osteomalacia is the softening of the bones caused by impaired bone metabolism primarily due to inadequate levels of available phosphate, calcium, and vitamin D, or because of resorption of calcium. The impairment of bone metabolism causes inadequate bone mineralization. Osteomalacia in children is known as rickets, and because of this, use of the term `` osteomalacia '' is often restricted to the milder, adult form of the disease. Signs and symptoms can include diffuse body pains, muscle weakness, and fragility of the bones. In addition to low systemic levels of circulating mineral ions necessary for bone and tooth mineralization, accumulation of mineralization - inhibiting proteins and peptides ( such as osteopontin and ASARM peptides ) occurs in the extracellular matrix of bones and teeth, likely contributing locally to cause matrix hypomineralization ( osteomalacia ). The most common cause of osteomalacia is a deficiency of vitamin D, which is normally derived from sunlight exposure and, to a lesser extent, from the diet. The most specific screening test for vitamin D deficiency in otherwise healthy individuals is a serum 25 ( OH ) D level. Less common causes of osteomalacia can include hereditary deficiencies of vitamin D or phosphate ( which would typically be identified in childhood ) or malignancy. Vitamin D and calcium supplements are measures that can be used to prevent and treat osteomalacia. Vitamin D should always be administered in conjunction with calcium supplementation ( as the pair work together in the body ) since most of the consequences of vitamin D deficiency are a result of impaired mineral ion homeostasis. Nursing home residents and the homebound elderly population are at particular risk for vitamin D deficiency, as these populations typically receive little sun exposure. In addition, both the efficiency of vitamin D synthesis in the skin and the absorption of vitamin D from the intestine decline with age, thus further increasing the risk in these populations. Other groups at risk include individuals with malabsorption secondary to gastrointestinal bypass surgery or celiac disease, and individuals who immigrate from warm climates to cold climates, especially women who wear traditional veils or dresses that prevent sun exposure. Contents 1 Signs and symptoms 2 Causes 3 Diagnosis 3.1 Biochemical findings 3.2 Radiographic characteristics 4 Treatment 5 Etymology 6 See also 7 References Signs and symptoms Osteomalacia is a generalized bone condition in which there is inadequate mineralization of the bone. Many of the effects of the disease overlap with the more common osteoporosis, but the two diseases are significantly different. There are two main causes of osteomalacia : insufficient calcium absorption from the intestine because of lack of dietary calcium or a deficiency of, or resistance to, the action of vitamin D phosphate deficiency caused by increased renal losses. Symptoms : Diffuse joint and bone pain ( especially of spine, pelvis, and legs ) Muscle weakness Difficulty walking, often with waddling gait Hypocalcemia ( positive Chvostek sign ) Compressed vertebrae and diminished stature Pelvic flattening Weak, soft bones Easy fracturing Bending of bones Osteomalacia in adults starts insidiously as aches and pains in the lumbar ( lower back ) region and thighs before spreading to the arms and ribs. The pain is symmetrical, non-radiating and accompanied by sensitivity in the involved bones. Proximal muscles are weak, and there is difficulty in climbing up stairs and getting up from a squatting position. As a result of demineralization, the bones become less rigid. Physical signs include deformities like triradiate pelvis and lordosis. The patient has a typical `` waddling '' gait. However, these physical signs may derive from a previous osteomalacial state, since bones do not regain their original shape after they become deformed. Pathologic fractures due to weight bearing may develop. Most of the time, the only alleged symptom is chronic fatigue, while bone aches are not spontaneous but only revealed by pressure or shocks. It differs from renal osteodystrophy, where the latter shows hyperphosphatemia. Causes The causes of adult osteomalacia are varied, but ultimately result in a vitamin D deficiency : Insufficient nutritional quantities or faulty metabolism of vitamin D or phosphorus Renal tubular acidosis Malnutrition during pregnancy Malabsorption syndrome Hypophosphatemia Chronic kidney failure Tumor - induced osteomalacia ( Oncogenic osteomalacia ) Long - term anticonvulsant therapy Celiac disease Cadmium poisoning, itai - itai disease Diagnosis Biochemical findings Biochemical features are similar to those of rickets. The major factor is an abnormally low vitamin D concentration in blood serum. Major typical biochemical findings include : Low serum and urinary calcium Low serum phosphate, except in cases of renal osteodystrophy Elevated serum alkaline phosphatase ( due to an increase in compensatory osteoblast activity ) Elevated parathyroid hormone ( due to low calcium ) Furthermore, a technetium bone scan will show increased activity ( also due to increased osteoblasts ). Comparison of bone pathology view talk Condition Calcium Phosphate Alkaline phosphatase Parathyroid hormone Comments Osteopenia unaffected unaffected normal unaffected decreased bone mass Osteopetrosis unaffected unaffected elevated unaffected thick dense bones also known as marble bone Osteomalacia and rickets decreased decreased elevated elevated soft bones Osteitis fibrosa cystica elevated decreased elevated elevated brown tumors Paget 's disease of bone unaffected unaffected variable ( depending on stage of disease ) unaffected abnormal bone architecture Radiographic characteristics Radiological appearances include : Pseudofractures, also called Looser 's zones. Protrusio acetabuli, a hip joint disorder Treatment Nutritional osteomalacia responds well to administration of 10,000 IU weekly of vitamin D for four to six weeks. Osteomalacia due to malabsorption may require treatment by injection or daily oral dosing of significant amounts of vitamin D. Etymology Osteomalacia is derived from Greek : osteo - which means `` bone '', and malacia which means `` softness ''. In the past, the disease was also known as malacosteon and its Latin - derived equivalent, mollities ossium. Osteomalacia is associated with increase in osteoid maturation time. See also Osteopetrosis References Jump up ^ Salmon, B ; Bardet, C ; Coyac, BR ; Baroukh, B ; Naji, J ; Rowe, PS ; Opsahl Vital, S ; Linglart, A ; Mckee, MD ; Chaussain, C ( August 2014 ). `` Abnormal osteopontin and matrix extracellular phosphoglycoprotein localization, and odontoblast differentiation, in X-linked hypophosphatemic teeth. ''. Connective tissue research. 55 Suppl 1 : 79 -- 82. PMID 25158186. doi : 10.3109 / 03008207.2014. 923864. Jump up ^ Boukpessi, T ; Hoac, B ; Coyac, BR ; Leger, T ; Garcia, C ; Wicart, P ; Whyte, MP ; Glorieux, FH ; Linglart, A ; Chaussain, C ; McKee, MD ( 21 November 2016 ). `` Osteopontin and the dento - osseous pathobiology of X-linked hypophosphatemia. ''. Bone. 95 : 151 -- 161. PMID 27884786. doi : 10.1016 / j. bone. 2016.11. 019. Jump up ^ Barros, NM ; Hoac, B ; Neves, RL ; Addison, WN ; Assis, DM ; Murshed, M ; Carmona, AK ; McKee, MD ( March 2013 ). `` Proteolytic processing of osteopontin by PHEX and accumulation of osteopontin fragments in Hyp mouse bone, the murine model of X-linked hypophosphatemia. ''. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. 28 ( 3 ) : 688 -- 99. PMID 22991293. doi : 10.1002 / jbmr. 1766. Jump up ^ McKee, MD ; Hoac, B ; Addison, WN ; Barros, NM ; Millán, JL ; Chaussain, C ( October 2013 ). `` Extracellular matrix mineralization in periodontal tissues : Noncollagenous matrix proteins, enzymes, and relationship to hypophosphatasia and X-linked hypophosphatemia. ''. Periodontology 2000. 63 ( 1 ) : 102 -- 22. PMC 3766584. PMID 23931057. doi : 10.1111 / prd. 12029. Jump up ^ Boukpessi, T ; Gaucher, C ; Léger, T ; Salmon, B ; Le Faouder, J ; Willig, C ; Rowe, PS ; Garabédian, M ; Meilhac, O ; Chaussain, C ( August 2010 ). `` Abnormal presence of the matrix extracellular phosphoglycoprotein - derived acidic serine - and aspartate - rich motif peptide in human hypophosphatemic dentin. ''. The American Journal of Pathology. 177 ( 2 ) : 803 -- 12. PMC 2913338. PMID 20581062. doi : 10.2353 / ajpath. 2010.091231. Jump up ^ MedlinePlus Medical Encyclopedia : Osteomalacia Jump up ^ Longo, Dan L. ; et al. ( 2012 ). Harrison 's principles of internal medicine. ( 18th ed. ). New York : McGraw - Hill. ISBN 978 - 0 - 07174889 - 6. Jump up ^ Longo, Dan L. ; et al. ( 2012 ). Harrison 's principles of internal medicine. ( 18th ed. ). New York : McGraw - Hill. ISBN 978 - 0 - 07174889 - 6. Jump up ^ Kennel, KA ; Drake, MT ; Hurley, DL ( August 2010 ). `` Vitamin D deficiency in adults : when to test and how to treat. ''. Mayo Clinic Proceedings. 85 ( 8 ) : 752 -- 7 ; quiz 757 -- 8. PMC 2912737. PMID 20675513. doi : 10.4065 / mcp. 2010.0138. Jump up ^ Chakravorty, N.K. ( 1980 ). `` Triradiate deformity of the pelvis in Paget 's disease of bone. ''. Postgraduate Medical Journal. 56 ( 653 ) : 213 -- 5. PMC 2425842. PMID 7393817. doi : 10.1136 / pgmj. 56.653. 213. Jump up ^ `` Autoimmunity research foundation, Science behind Vitamin D ''. Retrieved 2011 - 07 - 19. Jump up ^ Pack, Alison ( 2008 ). `` Bone health in people with epilepsy : is it impaired and what are the risk factors ''. Seizure. 17 ( 2 ) : 181 -- 6. PMID 18187347. doi : 10.1016 / j. seizure. 2007.11. 020. Jump up ^ Albany, Costantine ; Servetnyk, Zhanna ( 2009 ). `` Disabling osteomalacia and myopathy as the only presenting features of celiac disease : a case report ''. Cases Journal. 2 ( 1 ) : 20. PMC 2626577. PMID 19128487. doi : 10.1186 / 1757 - 1626 - 2 - 20. Jump up ^ Holick, Michael F. ( 19 July 2007 ). `` Vitamin D Deficiency ''. New England Journal of Medicine. 357 ( 3 ) : 266 -- 281. PMID 17634462. doi : 10.1056 / NEJMra070553. Jump up ^ Eisman, John A. ( 1988 ). `` 6 Osteomalacia ''. Baillière 's Clinical Endocrinology and Metabolism. 2 : 125 -- 55. doi : 10.1016 / S0950 - 351X ( 88 ) 80011 - 9. Malnutrition or nutrition disorders ( E40 -- E68, 260 -- 269 ) Malnutrition Protein - energy malnutrition Kwashiorkor Marasmus Catabolysis Vitamin deficiency B vitamins B : Beriberi / Wernicke -- Korsakoff syndrome ( Wernicke 's encephalopathy Korsakoff 's syndrome ) B : Riboflavin deficiency B : Pellagra ( Niacin deficiency ) B : Pyridoxine deficiency B : Biotin deficiency B : Folate deficiency B : Vitamin B deficiency Other vitamins A : Vitamin A deficiency / Bitot 's spots C : Scurvy D: Vitamin D deficiency / Rickets / Osteomalacia E : Vitamin E deficiency K : Vitamin K deficiency Mineral deficiency Sodium Potassium Magnesium Calcium Iron Zinc Manganese Copper Iodine Chromium Molybdenum Selenium ( Keshan disease ) Overnutrition Overweight Obesity Childhood obesity Obesity hypoventilation syndrome Abdominal obesity Vitamin poisoning Hypervitaminosis A Hypervitaminosis D Hypervitaminosis E Mineral overload see inborn errors of metal metabolism, toxicity Bone and joint disease ( M80 -- M94, 730 -- 733 ) Bone Inflammation endocrine : Osteitis fibrosa cystica Brown tumor infection : Osteomyelitis Sequestrum Involucrum Sesamoiditis Brodie abscess Periostitis Vertebral osteomyelitis Metabolic Bone density Osteoporosis Juvenile Osteopenia Osteomalacia Paget 's disease of bone Bone resorption Osteolysis Hajdu - Cheney syndrome Ainhum Other Ischaemia Avascular necrosis Osteonecrosis of the jaw Algoneurodystrophy Hypertrophic pulmonary osteoarthropathy Nonossifying fibroma Pseudarthrosis Stress fracture Fibrous dysplasia Monostotic Polyostotic Skeletal fluorosis bone cyst Aneurysmal bone cyst Hyperostosis Infantile cortical hyperostosis Osteosclerosis Melorheostosis Pycnodysostosis Joint Chondritis Relapsing polychondritis Other Tietze 's syndrome Combined Osteochondritis Osteochondritis dissecans Child leg : hip Legg -- Calvé -- Perthes syndrome tibia Osgood - Schlatter disease Blount 's disease foot Köhler disease Sever 's disease spine Scheuermann 's disease arm : wrist Kienbock 's disease elbow Panner disease Retrieved from `` https://en.wikipedia.org/w/index.php?title=Osteomalacia&oldid=792298485 '' Categories : Pediatrics Osteopathies Vitamin D Hidden categories : All articles with unsourced statements Articles with unsourced statements from February 2017 Articles with unsourced statements from November 2014 Talk Contents About Wikipedia Bosanski Català Deutsch Español فارسی Français Gaeilge Galego 한국어 Հայերեն हिन्दी Hrvatski Bahasa Indonesia Italiano Қазақша Кыргызча Lietuvių Nederlands Polski Português Русский کوردی Suomi Svenska Türkçe 粵語 Edit links This page was last edited on 25 July 2017, at 18 : 30. Text is available under the Creative Commons Attribution - ShareAlike License ; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia ® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. About Wikipedia

Question: softening of the bones in adults is known as
Answer: osteomalacia