When the newly formed bone of the growth plate does not mineralize, the growth plate becomes wide and irregular. This results in the clinical diagnosis of rickets, and is seen only in children because adults no longer have growth plates. When the remodeled bone does not mineralize, osteomalacia occurs, and this happens in all ages. Most of the hereditary causes of osteomalacia appear during childhood and cause rickets. A photomicrograph of a biopsy from a normal postmenopausal woman showing an osteoid seam of normal width.
Mineralized bone is green and osteoid is orange.
The orange-staining osteoid covers many surfaces and is thicker than normal. The second photo is from part of the biopsy that was decalcified and thus it appears normal. The osteomalacia cannot be appreciated. Both photos from the same section of a bone biopsy. Near the cortex is osteomalacia.