Download - Bone demineralization
Bone Demineralizationproblem based learning (pbl)
PREPARED BY :MUHAMMAD ARIFF B MAHDZUB
BACHELOR MEDICINE AND SURGERY (MBBS)
UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN
Bone Demineralization
Structural abnormalities caused by defective mineralization of bone & an increase in
nonmineralised osteoid.
• Rickets
– defective mineralization of developing bones in children
• Osteomalacia
– defective mineralization of bone that has completed its normal development.
3
Rickets
Osteomalacia
An x- ray showing a pseudofracture (arrow) .This is a classic pseudofracture
and is pathognomonic of osteomalacia.
Vitamin D & calcium balance
Decrease 25(OH)D (liver)
– Inadequate exposure to sun light
– Inadequate dietary vitamin D
– Vitamin D malabsorption
– Sever hepatocellular disease
Causes of decrease 1,25(OH)2D (intestine)
– Renal failure
– Hyperphosphatemia (increase PO4)
– Hypoparathyroidism
Rickets and Osteomalacia
• Clinical manifestation of rickets and osteomalacia are a
consequence of defect in mineralization.
• bone formation is affected, leading to skeletal deformities
– Bowing of the extremities
– Short stature
– Costochondral-junction swelling - (rachitic rosary).
– Flattening of the skull.
• In adults bone pain is the most common symptom, stress
skeletal fractures may occur.
Rickets and Osteomalacia
• Lab findings:
– Low serum calcium
– Low serum phosphate
– High ALP
• Radiological appearances
– diffuse radiolucency of bone (osteopenia)
Rachitic rosary
Rachitic rosary
Osteomalacia
An x- ray showing a pseudofracture (arrow) .This is a classic pseudofracture
and is pathognomonic of osteomalacia.
Rickets and Osteomalacia
Treatment:
• Vit D
• Ca, PO4 supplement