Bone & joints

Other nonneoplastic

Rickets / osteomalacia

Last author update: 1 August 2013
Last staff update: 20 September 2023

Copyright: 2003-2023,, Inc.

PubMed Search: Rickets osteomalacia[title]

Nat Pernick, M.D.
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Cite this page: Pernick N. Rickets / osteomalacia. website. 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
  • 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
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