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Osteomalacia and Rickets

Patrick M Carey, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A metabolic bone disorder characterized by decreased bone mineralization (calcification) that results in decreased bone density

  • Referred to as renal osteodystrophy when secondary to r...

DIAGNOSIS

HISTORY

  • Common presentations in children (3)

    • Muscle weakness: may not be able to stand until age 3 years

    • Bowed legs

    • Diffuse limb pain

    • Hypocalcemic seizures

    • Carpopedal spasms

  • Common presentations i...

TREATMENT

MEDICATION

A combination of calcium and vitamin D is recommended (5)[A]. 

First Line

  • Calcium 1,000 mg/day PO

  • Children with vitamin D–deficiency rickets (6)[A]

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • For children, monitor the following:

    • Serum calcium, phosphorus, alkaline phosphatase, calcidiol

  • For adults taking calcium supplements, monitor plasma calcium levels

DIET

REFERENCES

1
Pettifor  JM. Nutritional rickets: pathogenesis and prevention. Pediatr Endocrinol Rev.  2013; 10(Suppl 2): 347– 353.  [View Abstract] ...

ADDITIONAL READING

  • American College of Obstetricians Committee on Obstetric Practice. ACOG Committee Opinion No. 495: vitamin D: screening and supplementation during pregnan...

CODES

ICD10

  • M83.9 Adult osteomalacia, unspecified

  • E55.0 Rickets, active

  • N25.0 Renal osteodystrophy

  • M83.1 Senile osteomalacia

  • M83.5 Other drug-induced osteomalacia in adults

  • M83.4 Aluminum bone disease

  • M83.3 ...

CLINICAL PEARLS

  • In the United States, rickets occurs almost exclusively in breastfed infants without vitamin D supplementation or sun exposure.

  • Children and adolescents with increased skin pigmentation...

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