Osteomalacia

Rickets (Osteomalacia): Complications

The following are the most important diseases or complications that may be contributed to by rickets or osteomalacia: Endocrine, nutritional, and metabolic diseases (E00-E90). Hypocalcemia (calcium deficiency) → tetany (disturbance of motor function and sensitivity due to hyperexcitability of nerves and muscles). Musculoskeletal system and connective tissue (M00-M99). Skeletal changes due to decreased mineralization of … Rickets (Osteomalacia): Complications

Rickets (Osteomalacia): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination-including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin Gait pattern [waddling gait?; evidence of muscular weakness?] Stand-up and walk test (“Timed Up and Go” test): stand up from a chair (with armrests!), walk 3 m forward to an … Rickets (Osteomalacia): Examination

Rickets (Osteomalacia): Test and Diagnosis

1st-order laboratory parameters-obligatory laboratory tests. Calcium* [n/↓] Phosphate* [n/↓] Alkaline phosphatase (AP)* [↑] – typical in osteomalacia, but not specific DD bone metastases. Parathyroid hormone (PTH)* [↑- ↑↑] 25-hydroxyvitamin D (25(OH)-vitamin D3 ; 25-OH-D3), plasma [↓-↓↓] 1,25-(OH)2-vitamin D (1,25-OH-D3), plasma [n-↑]Note: 1,25(OH)2-vitamin D3 levels ↓ + normal 25(OH)-vitamin D3 → synthesis disorder of vitamin D3. … Rickets (Osteomalacia): Test and Diagnosis

Rickets (Osteomalacia): Drug Therapy

Therapeutic Objective Remediation of demineralization Therapy recommendations Therapy recommendations depending on the indications: Rickets: cholecalciferol (vitamin D3);calcium substitution. Osteomalacia: Cholecalciferol (vitamin D3), orally or Vitamin D conversion disorders and hypophosphatemic osteomalacia: calcitriol, orally and calcium substitution. Hypophosphatemia (primarily remediation of the cause); if not causally treatable cause such as Fanconi syndrome: phosphate and calcitriol substitution. … Rickets (Osteomalacia): Drug Therapy

Rickets (Osteomalacia): Diagnostic Tests

Obligatory medical device diagnostics. Conventional radiographs of affected bones – show in the presence of rickets or osteomalacia: Calcified skeleton with fused bone structure (classic milk glass structure of the bones). Characteristic Loosersche remodeling zones (bilateral and symmetrically arranged, ligamentous, low-calcification zones; in typical localizations are lateral scapular rim (lateral scapula), proximal humerus (humerus), upper … Rickets (Osteomalacia): Diagnostic Tests

Rickets (Osteomalacia): Prevention

To prevent rickets or osteomalacia, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Micronutrient deficiency (vital substances) – see Prevention with micronutrients. Lack of UV irradiation

Rickets (Osteomalacia): Symptoms, Complaints, Signs

Children The following symptoms and complaints may indicate rickets: In addition to symptoms of hypocalcemia (calcium deficiency) with a tendency to tetany, there are typical skeletal changes (development of the epiphyses is disturbed and the cartilage-bone junction of the growth plates is distended). Symptoms Adynamia Gait disturbance Hair loss Itchy exanthema (skin rash) Seizures – … Rickets (Osteomalacia): Symptoms, Complaints, Signs

Rickets (Osteomalacia): Causes

Pathogenesis (development of disease) There are many causes of rickets or osteomalacia. Rickets In all forms of rickets, there are changes in the calcium–phosphate product. There is decreased storage of calcium and phosphate in the bones. One can distinguish calcipenic from phosphopenic forms of rickets: Calcipenic rickets (E83.31) include: Hypocalcemia Vitamin D deficiency Vitamin D-dependent … Rickets (Osteomalacia): Causes

Rickets (Osteomalacia): Therapy

General Measures Sufficient sun exposure Review of permanent medication due topossible effect on the existing disease. Regular check-ups Regular medical checkups Nutritional medicine Nutritional counseling based on nutritional analysis Nutritional recommendations according to a mixed diet taking into account gender and age. Observance of the following special nutritional recommendations: Vitamin D-rich diet (supplementation with 800-1,000 … Rickets (Osteomalacia): Therapy

Rickets (Osteomalacia): Medical History

Medical history (history of illness) represents an important component in the diagnosis of rickets or osteomalacia. Family history What is the general health status of your relatives? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). … Rickets (Osteomalacia): Medical History

Rickets (Osteomalacia): Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Crux varum congenitum and tibia vara; both usually unilateral, in contrast to rickets Endocrine, nutritional, and metabolic diseases (E00-E90). Calcipenic rickets [due todecreased serum calcium → elevated parathyroid hormone] Hypophosphatasia (HPP; synonyms: Rathbun syndrome, phosphatase deficiency rickets; phosphatase deficiency rickets) – rare, genetic, currently incurable bone metabolism disorder … Rickets (Osteomalacia): Or something else? Differential Diagnosis