Endocrine & metabolic · UKMLA & AKT
Osteomalacia
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise osteomalacia — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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