Osteomalacia and Rickets

The minerals calcium and phosphate give bone its strength and density. A deficiency of vitamin D results in poor absorption of calcium from the diet, leading to weak and soft bones that are easily deformed or fractured. In adults, the condition is called osteomalacia; in children, it is known as rickets.

Normal And Osteomalacia.

What are the causes?

Healthy people obtain the vitanmin D they need partly from their diet (from eggs, fish, green vegetables, fortified margarine, and milk) and partly from vitamin D production in the skin on exposure to sunlight. A deficiency of vitamin D, therefore, is most common in people who eat a restricted diet and receive little direct sunlight. In tropical countries, vitamin D deficiency is almost unknown, except in women who are required to cover their entire bodies. At higher latitudes, deficiency may occur in elderly, housebound people.

Some people cannot absorb vitamin D from food due to intestinal surgery or coeliac diseases. Less commonly, osteomalacia and rickets may be caused by inherited disorders of vitamin D metabolism or chronic kidney failure. In rare cases, drugs used to treat epilepsy interfere with vitamin D metabolism and cause osteomalacia or rickets.


What are the symptoms?

The symptoms of osteomalacia develop over months or years and may include:

- Painful, tender bones, most often the ribs,hips, and bones of the legs.
- Difficulty in climbing stairs or in getting up from a squatting position.
- Bone fractures after a minor injury.

A child with rickets may experience similar symptoms, and may also have:

- Retarded growth.
- Swelling and tenderness at the growing ends of the bones.
- Prominence of the ribs where they join the breastbone.

Left untreated, bow legs or knock-knees may develop in affected children.

What might be done?

Your doctor may suspect osteomalacia or rickets from your symptoms and a physical examination. He or she may arrange for blood tests to check for low levels of calcium, phosphate, and vitamin D. A bone biopsy, in which a bone sample is taken for analysis, or X-rays can confirm the diagnosis.

If you have a vitamin D deficiency, you should eat foods rich in vitamin D and increase your exposure to sunlight. If you have a disorder that prevents absorption of the vitamin from food, you may need to have vitamin D injections. Calcium supplements may also be required.

After treatment, most people make a full recovery, although deformities that occur in childhood may be permanent.