RICKETS AND OSTEOMALACIA
 
Commonly seen in Asian country. Inadequate bone mineralization due to deficiency of calcification . Normal bone mass present.
 
Rickets:

When in occurs in growing children

 

 
Osteomalacia: In adult after the growth spurts
   
Inadequate Calcium:

Inadequate intake of calcium.
Defect in metabolic pathway of Vit D3.
Inadequate exposure to sunlight
Intestinal malabsorption
Renal or liver disease.

   

Rickets:

 
Clinical features:  

Failure to thrive, listlessness, muscular flaccidity, Soft skull,
Thickening of knees, ankles and wrists
Bowing / of the legs. Knock knees
Lag of growth
Scoliosis / Kyphosis of spine
Long bones deformities and fractures                       

   
Osteomalacia :    

Bone pains, backaches, muscle weakness, Kyphosis, Stress fractures.

   
Investigations

Serum Calcium & Phosphorus – Decreased
Alkaline PO4 – Decreased
Urine Calcium – Decreased
Vitamin D3 – Decreased

   
Treatment:

Varies on the cause

 
  • Vit D3 Deficiency – Given Vit D3 + Ca++
  • Vit D3 Deficiency to intestinal malabsorption – large doses of Vit D ~ 50,000 IV/day
  • Renal Rickets – 1,25 Dihydroxycholicalcifenec  (calcitriol)
   
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