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Osteomalacia and rickets

Last updated: August 11, 2021

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Osteomalacia is a disorder of impaired mineralization of the osteoid; rickets is a disorder of impaired mineralization of cartilaginous growth plates. Adults have fused growth plates so they are only affected by osteomalacia. In children, whose growth plates are open, the disorders can occur simultaneously. The most common cause of both osteomalacia and rickets is vitamin D deficiency resulting from inadequate intake, malabsorption, or lack of exposure to sunlight. Patients with osteomalacia usually present with bone pain and tenderness, while patients with rickets exhibit bone deformities and impaired growth. Over time, both conditions may lead to bending of the long bones or even pathologic fractures. Treatment consists of administering vitamin D and ensuring sufficient calcium intake.

Vitamin D‑dependent forms (most common)

Vitamin D deficiency [1][2][3][4]

Defective vitamin D metabolism

Vitamin D‑independent forms (rare)

Vitamin D deficiency and defective vitamin D metabolism [9]

Vitamin D-independent forms

Osteomalacia

Rickets

Laboratory tests

Imaging

Imaging findings in osteomalacia and rickets

Osteomalacia Rickets
Bone mineral density
Cortices
  • Thinned
Other findings

Bone biopsy

  • Can be useful to establish diagnosis, identify the underlying pathomechanism, and study bone metabolism
  • Iliac bone is used for biopsy

Osteomalacia

Rickets [12]

Congenital pseudarthrosis of the tibia

The differential diagnoses listed here are not exhaustive.

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