Osteomalacia: NEET PG High-Yield
Metabolic Bone Disease: Softening of Bone
1. Pathophysiology
Defective mineralization of the organic bone matrix (osteoid) in adults leads to soft, weak bones. It is the adult equivalent of Rickets in children.
2. Key Clinical & Radiographic Features
| Feature | Description |
|---|---|
| Looser’s Zones | “Milkman’s lines” or pseudo-fractures; pathognomonic radiolucent lines perpendicular to the cortex. |
| Biochemistry | Decreased Vitamin D, decreased Calcium, decreased Phosphate, increased Alkaline Phosphatase (ALP). |
| Clinical Presentation | Diffuse bone pain, muscle weakness (proximal myopathy), and waddling gait. |
3. High-Yield NEET Pearls
- Rickets vs. Osteomalacia: Both are mineralization defects. Rickets occurs *before* epiphyseal closure, while Osteomalacia occurs *after* closure.
- Common Causes: Vitamin D deficiency (dietary, lack of sun exposure), malabsorption, or renal tubular acidosis (RTA).
- Differential: If bone pain is present with elevated ALP but normal Calcium/Phosphate, consider Paget’s Disease or skeletal metastases.
- Treatment: Vitamin D (ergocalciferol/cholecalciferol) and Calcium supplementation.
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