Osteomalacia Misdiagnosis

Osteomalacia is a bone disorder that is most often caused by either the body’s inability to absorb vitamin D or insufficient calcium in the diet. Symptoms include weak, soft bones, pain in the arms, legs, spine and hips and susceptibility to low-impact fractures. There are several reasons a vitamin D deficit may occur, ranging from low exposure to sunlight to poor diet to intestinal malabsorption.

If the cause is low levels of calcium, symptoms may include numbness, muscle spasms, and irregular heartbeat. Less common causes of osteomalacia include cancer, liver and kidney disease, as well as medication side effects, or heredity. In children, the condition is called rickets and causes bowing in the large bones of the legs.

Misdiagnosis of Osteomalacia

Although similar to osteoporosis, osteomalacia there are some differences. Osteoporosis is a gradual thinning of bones due to lack of calcium and causes bones to become brittle, where osteomalacia is due to improper mineralization of bones, making them soft and flexible. Because both conditions result in pain and fractures, one can sometimes be mistaken for the other. Another key difference between these two disorders is that osteomalacia can be cured in 6 to 8 months if proper diagnosis and treatment are undertaken, where treatment for osteoporosis continues indefinitely.

Osteomalacia can also be mistaken for rheumatoid arthritis, fibromyalgia or parathyroidism because the early symptoms of bone pain, muscle weakness and general fatigue are the same. In rare cases, the intense bone pain of severe osteomalacia can be confused with that of metastatic cancer.

Proper Diagnosis and Treatment

Fortunately, osteomalacia is easily cured when properly diagnosed. Bone x-rays, bone density testing, blood tests that determine calcium, phosphate and creatinine levels and bone biopsies to identify softening are critical diagnostic procedures. Because osteomalacia can occur as a result of the following diseases, further testing may be conducted for liver disease, kidney disease or parathyroidism. For primary osteomalacia, treatment is simple once diagnosis is made. Oral supplements of vitamin D, calcium and phosphorus are all that is required. In some cases, increased exposure to sunlight can aid the body’s ability to absorb vitamin D. Supplements may be increased for those patients with intestinal problems that prevent quick absorption of vitamins and minerals. Improvement may often be seen in as early as two to four weeks.