Endocrine & metabolic · UKMLA & AKT
Osteomalacia
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Bone pain - diffuse, dull, aching; spine, pelvis, hips, lower limbs; worse with weight-bearing and direct pressure
- Proximal muscle weakness - characteristic; caused by calcitriol deficiency and impaired calcium-mediated muscle contraction
- Waddling gait - due to proximal lower limb myopathy
- Insufficiency fractures - minimal trauma; femoral neck, pubic rami, ribs, metatarsals
- Features of hypocalcaemia (severe cases) - perioral paraesthesia, tetany, Chvostek's sign, Trousseau's sign
Bone pain + proximal muscle weakness in an adult should always prompt consideration of osteomalacia - this combination is far more typical of osteomalacia than osteoporosis (which is usually asymptomatic until fracture).
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