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Osteomalacia (Aetiology (Drug-induced (Anticonvulsants may induce liver…
Osteomalacia
Aetiology
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Renal osteodystrophy
Renal failure leads to 1,2-dihydroxy-cholecalciferol deficiency
Liver disease
Due to reduced hydroxylation of vitamin D to 25-hydroxy-cholcecalciferol and malabsorption of vitamin D e.g. in cirrhosis
Vitamin D deficiency
Due to malabsorption, poor diet or lack of sunlight
Tumour induced
Mediated by raised tumour production of phosphatonin fibroblast growth factor which causes hyperphosphaturia
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Investigations
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X-ray: Loss of cortical bone, partial fractures. Ragged metaphyseal surfaces are seen in rickets
Plasma: mildly low Ca, low phosphate, high ALP + PTH, low vitamin D
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Definition
There is a normal amount of bone but its mineral content is low. The reverse of osteoporosis (mineralization is normal but there is low bone mass)