Osteomalacia

Vitamin D

1. Osteomalacia Zaryab Ghauri Batch E

2. What is Osteomalacia? Osteomalacia means soft bones often develops because of vitamin D deficiency.

3. Who gets Osteomalacia? Elder People Family History of Rickets Black Race South Asian Origin

4. Bone Mineralization Bone Mineral Hydroxyapatite [Ca10(PO4)6(OH)2] Vitamin D(Metabolism)

5. Vitamin D(Functions) *Intestinal Calcium absorption *Re-absorption of Calcium from Kidneys *Interaction with PTH in regulation of blood Calcium *Mineralization of Bone

6. Osteoclasts Osteoblasts Osteocytes Lining Cells

7. Pathology in Osteomalacia Inadequately mineralized Osteoid

8. Causes Of Osteomalacia 1. Vitamin D deficiency Diet Sun Exposure

9. 2. Gastrointestinal Causes Gastric Intestinal Billiary 3. Renal Causes Chronic Renal Failure Renal Tubular Acidosis Long term Renal Dialysis Fanconi Syndrome(Poisoning)

10. 4. Tumor Induced Osteomalacia 5. Drugs Phenobarbital ( Pubmed ) Acetazolamide ( JAMA, Journal of the American Medical Association) Ammonium Chloride (http://press.endocrine.org/doi/abs/10.1210/jcem-16-5-599) Disodium Etidronate (http://www.ncbi.nlm.nih.gov/pubmed/10883448) Flouride (http://fluoridealert.org/studies/osteoid02/)

11. Symptoms >50yrs age Bone Pain Muscle Weakness Easy Fractures

12. Investigations CBC Electrolytes Levels Of Calcium Phosphorus Calcium Phosphorus Index Vitamin D ALP PTH

13. Looser’s Zone

14. Codfish Vertebrae

15. Trefoil Pelvis

16. Bone Scan

17. Treatment Sun Exposure Diet Vitamin D supplementation

18. Prevention

19. References http://painreliveonlypt.blogspot.com/2014/10/osteomalacia-causes-risk-factors.html http://www.arthritisresearchuk.org/arthritis-information/conditions/osteomalacia/what-is-osteomalacia.aspx http://www.vitaminsestore.com/osteomalacia-causes-treatments-symptoms-and-risk-factors/