Bone & joints
Other nonneoplastic
Rickets / osteomalacia
Author: Nat Pernick, M.D.
Last author update: 1 August 2013
Last staff update: 20 September 2023
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Rickets osteomalacia[title]
Table of Contents
Definition / general | Diagnosis | Radiology description | Microscopic (histologic) descriptionCite this page: Pernick N. Rickets / osteomalacia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bonerickets.html. Accessed September 30th, 2023.
Definition / general
- Defect in matrix mineralization due to Vitamin D disturbance (deficiency, abnormal metabolism or calcium deficiency)
- Causes accumulation of unmineralized bone matrix
- Various causes related to decreased serum calcium or phosphorus, including rare inborn errors of metabolism or common chronic renal failure; also phosphaturic mesenchymal tumor
- Associated with vague, generalized bone pain or muscle weakness (due to hypocalcemia)
- Rickets: children with irregular, broadened, cup shaped epiphyseal growth plates around knee and wrist
- Osteomalacia: adults, bone formed during remodeling is undermineralized, causes osteopenia and fractures
- Hypophosphatemia: usually due to renal tubular defect, diuretics, hyperparathyroidism; rarely due to a vascular tumor
Diagnosis
- Biopsy of long bone or iliac crest
Radiology description
- Generalized osteopenia with multiple bilateral and symmetrical linear fractures (insufficiency or stress fractures)
Microscopic (histologic) description
- Adults: wide, noncalcified matrix surrounding disorganized bone trabeculae; junction between osteoid and mineralized bone is irregular and granular; may be increased bone volume
- Children: thickened, poorly defined growth plate, particularly on metaphyseal side; tongues of uncalcified cartilage may extend into metaphysis; wide osteoid seams
