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OsteomalaciaRickets
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X-ray Slight cracks in the bones which are visible on x-rays known as looser ... is injected in the vein and a picture of the amount of radioactive dye gathers ... – PowerPoint PPT presentation
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Title: OsteomalaciaRickets
1
Osteomalacia/Rickets
- Glenda Vazquez
2
Introduction
- Osteomalacia is known as the softening of bones
due to insufficient vitamin D, or problems with
the break down of this vitamin. This disease is
also known as rickets in children.Bones with
osteomalacia have sufficient amounts of collagen
which gives the bones their structure, but they
lack calcium. The softness of the bones is more
likely to cause bow and fractures.
3
Causes/Rick Factors
- The most common cause of osteomalacia is a
deficiency of vitamin D. Vitamin D insufficiency
can cause osteomalacia because vitamin D
facilitates calcium absorption and other minerals
in the gastrointestinal tract necessary for bone
building. Lack of vitamin D, calcium and other
minerals arent absorbed efficiently, so they are
not available for mineralization in the bone
building process. This then result in soft bones.
- Insufficient sunlight exposure Sunlight makes
vitamin D in your skin. Therefore osteomalacia
can develop in people who spend little time in
the sunlight, wear very strong sunscreen, live in
areas where sunlight hours are short, or where
the air is smoggy. - Insufficient vitamin D intake A diet low in
vitamin D is the most common cause seen
worldwide. Is less common in the U.S. because
many foods, such as milk and cereals are
fortified with vitamin D. - Certain Surgeries The removal of part or all of
your stomach known as gastrectomy, can lead to
this disease because the stomach breaks down
foods to release vitamin D and other materials,
which are then absorbed by your intestines.
Surgery removing or bypassing your small
intestine can lead to osteomalacia. - Chronic pancreatitis Pancreatitis is the
long-standing inflammation of your pancreas, an
organ that makes digestive enzymes and hormones.
If the pancreas is inflamed enzymes in charge of
breaking down food and releasing nutrients do not
flow as freely into your intestines. - Chronic sprue In this autoimmune disorder, the
lining of the small intestine is damaged by
consuming foods having gluten, a protein found in
wheat, barley, and rye. Damaged intestinal lining
doesnt absorb nutrients, such as vitamin D, as
well as a healthy one would.
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Incidence/Prevalence
- In the United States it is estimated that 20 to
25 million people suffer from osteomalacia,
including 25 percent of women beyond menopause - Incidence of 1 per 1000 people in the United
States - Rickets In the U.S., severe nutritional rickets
has become rare, although the mild disorder
continues in the high-risk population (eg,
individuals with dark skin, persons who live in
inner-city areas). Breastfed infants who receive
no vitamin D supplementation also are at risk. - Rickets Incidence in Europe is similar to that
in the U.S. In sunny areas, such as in the Middle
East, rickets may occur when infants are bundled
in clothing and are not exposed to sunlight. In
some parts of Africa, deficiency of calcium
and/or phosphorous in the diet may lead to
rickets.
5
 Symptoms/Diagnosis
- In the early stages of osteomalacia a person may
not feel the symptoms, but may be seen in x-rays
or diagnostic tests. As osteomalacia worsens
symptoms may include bone pain and muscle
weakness. Bone pain is especially felt in the
lower spine, pelvis, legs and feet. The pain is
dull and aching and get worse with physical
activity. Even gentle pressure on the bone may
cause severe pain. - Osteomalacia may cause weakness and stiffness in
the arms and legs, decreased muscle tone and
discomfort during movement. Some people also walk
with a waddling motion. - When diagnosing osteomalacia, doctors will
inquire about the patients time spent in the sun
and about their diet. In order to rule out other
bone diseases the following tests may be
conducted - Blood and urine tests In the cases caused by
vitamin D deficiency or phosphorous loss,
abnormal levels of vitamin D and minerals calcium
and phosphorous are often detected through blood
and urine tests. - X-ray Slight cracks in the bones which are
visible on x-rays known as looser transformation
zones are characteristic of people with
osteomalacia      Bone scan Bone scans detect
areas of high and low bone metabolism in your
body. Radioactive dye is injected in the vein and
a picture of the amount of radioactive dye
gathers in your bones. Those with osteomalacia
have radioactive dye unevenly distributed in some
areas of their bones. - Bone biopsy A bone biopsy is performed by
inserting a slender needle through the skin and
into the bone to withdraw a small sample, which
is then viewed under a microscope. Even though
bone biopsies are very accurate in detecting
osteomalacia, it is often not needed to make the
diagnosis.
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Treatment
Before
After
- When osteomalacia is caused from a dietary or
sunlight deficiency, replenishing the low levels
of vitamin D in the body usually cures the
condition. Doctors also recommend vitamin D
supplements depending on the dose needed and
whether you have other health problems. Most
people with osteomalacia take vitamin D
supplements by mouth for several weeks or months.
Although uncommon, vitamin D can also be given as
an injection or through a vein in the arm. - If the blood levels of calcium and phosphorous
are low the patient may also take supplements of
these minerals. - After a patient begins treatment, they may
undergo periodic blood tests to assure blood
levels of vitamin D and certain minerals are
within normal limits. X-rays are also taken to
determine the improvement of the bones. Symptoms
may lessen within a few weeks of treatment.
Doctors suggest that patients continue taking
vitamin D indefinitely to prevent the return of
osteomalacia.
7
Prevention
- Osteomalacia caused by inadequate sun exposure
and a diet low in vitamin D can be prevented. - Spend a few minutes in the sun Direct exposure in
the sun to the arms and legs for five to ten
minutes daily is sufficient for adequate vitamin
D production. If a person lives in cold climate
and dont get enough sun exposure during the
winter, they can build enough vitamin D stores in
the skin during warmer months. Although regular
use of sunscreen helps prevent skin cancer and
premature aging of the skin, there is concern
that the frequent use of strong sunscreen can
increase the risk of developing ostemalacia. - Eat food high in vitamin D Eat foods that are
naturally rich in vitamin D such as oily fishes
(salmon, mackerel, and sardines) and egg yolks.
Other foods that are fortified with vitamin D
include cereal, bread, milk, and yogurt. - Take supplements If a person doesnt get enough
vitamins and minerals in their diet or if they
have a medical condition affecting the ability of
their digestive system to absorbing nutrients,
they are recommended to ask a doctor about taking
vitamin D and calcium supplements. - Exercise Exercise such as walking helps
strengthen bones, but if a patient has slight
fractures due to osteomalacia, they should avoid
strenuous activity until their bones heal.
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Questions
- 1. Osteomalacia is known as the softening of
bones due to insufficient vitamin D, or problems
with the break down of this vitamin. - A) True B) False
- 2. The most common cause of osteomalacia is ____.
- A) Vitamin D deficiency B) Lack of collagen
- C) Excess Vitamin D D) None
- 3. The softness of the bones is more likely to
cause bow and fractures. - A) True B) False
- 4. Osteomalacia can develop in people who a lot
little time in the sunlight. - A) True B) False
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