OSTEOMALACIA

Osteomalacia is a generalized bone disorder characterized by impairmen t of mineralization, leading to accumulation of unmineralized matrix o r osteoid in the skeleton. The classical clinical features of osteomal acia include musculoskeletal pain, skeletal deformity, muscle weakness and symptomatic hypocalcaemia. In childhood the features of osteomala cia are accompanied by rickets, with widening of the epiphyses and imp aired skeletal growth. The major cause of osteomalacia is vitamin D de ficiency, which is most often due to reduced cutaneous production of v itamin D in housebound elderly people, immigrants to Northern countrie s and women who adopt strict dress codes which prohibit exposure of un covered skin. Vitamin D deficiency osteomalacia may also occur with ma labsorption, liver disease and anticonvulsant therapy. Less commonly, osteomalacia may result from abnormal vitamin D metabolism, resistance to the action of vitamin D, hypophosphataemia or toxic effects on ost eoblast function.