Commonly seen in Asian country. Inadequate bone mineralization due to deficiency of calcification . Normal bone mass present.

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.



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.


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


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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