Xrays disclose osteopenia, Looser's zones or wide epiphyseal plates. There is renal phosphate loss, but renal function is otherwise normal. Amino-aciduria, renal tubular acidosis, or glucosuria indicate Fanconi's syndrome, which may resemble oncogenic osteomalacia. Calcium may be normal or slightly low. Parathyroid hormone is increased in some cases.
Alkaline phosphate is elevated.
Other routine biochemical tests are unremarkable. Bone biopsies demonstrate osteomalacia. These photomicrographs demonstrate serious osteomalacia. The osteoid is orange and the mineralized bone is green. The second view, at higher magnification and under polarized light, shows the lamellar nature of the osteoid.