Nutritional osteomalacia occurs after the growth plates have fused. It is often confused with osteoporosis and both conditions can occur together.


Although many adults with osteomalacia are elderly, the condition may occur at any age.


Clinical findings:

(1) easy fatigability

(2) malaise

(3) diffuse bone pain

(4) tenderness to bone palpation

(5) fracture after minor trauma, especially in proximal femur and vertebrae

(6) kyphosis

(7) proximal muscle weakness (may first be noticed in the lower extremities)


Imaging findings:

(1) osteopenia with blurring of the trabecular pattern

(2) Looser's zones (possibly healing fatigue fractures) in proximal humerus, proximal femur and pelvis


Laboratory findings:

(1) normal or decreased serum calcium

(2) normal or decreased serum phosphate

(3) increased serum alkaline phosphatase (not seen in osteoporosis)


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