Osteomalacia

Osteomalacia is a condition in which adult bones become abnormally soft because of impaired mineralization, typically due to vitamin D deficiency or disturbances in calcium and phosphate metabolism. Unlike osteoporosis (which reduces bone mass), osteomalacia affects bone quality, making structurally normal?volume bone mechanically weak and prone to bending or breaking.

Common causes include inadequate sun exposure, poor dietary intake of vitamin D and calcium, malabsorption disorders (such as celiac or Crohn’s disease), and chronic kidney or liver disease that disrupt vitamin D activation. People with limited outdoor activity, darker?pigmented skin, obesity, or strict vegetarian diets are at higher risk.

Typical symptoms are dull, diffuse bone pain (especially in hips, pelvis, and lower back), muscle weakness, difficulty climbing stairs, a waddling gait, and increased susceptibility to fractures from minor trauma. In advanced cases, bone deformities may appear.

Diagnosis relies on blood tests (vitamin D, calcium, phosphate, alkaline phosphatase), imaging (X?rays, DEXA), and occasionally bone biopsy. Treatment focuses on correcting vitamin D and calcium–phosphate deficits, managing underlying diseases, and encouraging sensible sun exposure and weight?bearing exercise to restore bone strength.