Tuesday, February 19, 2019

Osteomalacia


  • Osteomalacia is the disease in which the bone become abnormally soft because of a disturb calcium and phosphorus balance and secondary to vitamin D deficiency.
  • It is characterized by wide spread decalcification and softening of bone specially in the a spine , pelvis and lower extremities.
  • Osteomalacia is softening of the bone caused by impair bone metabolism primarily due to inadequate levels of the available calcium ,phosphorus and vitamin D or because excessive re-absorption of calcium.

Etiology :-

  • Improper diet
  • Strict vegeterianism
  • vitamin D deficiency
  • less expose to sunlight
  • Renal failure
  • Tumor induced or oncogenic osteomalacia 
  • Hyperthyroid induced osteopenia
  • Chronic or prolong used by Anti-convulsent drugs

Pathophysiology :-

  • Due to vitamin D deficiency or other risk factor
  • Improper or lack of calcium metabolism
  • Reduced the absorption of calcium in the bones
  • Bone become soft and bend
  • Susceptible to or leads to fracture

Clinical manifestation :-

  • Severe muscular and bone pain
  • Fatigue ,malaise
  • muscular weakness
  • Pseudo fracture / Milkman syndeome,stripe form in bones and seems like fracture 

Investigation :-

  • CT,MRI
  • X-ray
  • Dual energy X-ray
  • Blood test 
  • Biopsy (in case of oncogenic osteomalacia) 

Medical management :-

  • Analgesic to reduce severe pain
  • Expose to sunlight 
  • Dietary intake of vitamin D rich food or sources
  • 2000-10000 IV vitamin D ,4-6 weeks orally if malabsorption administered through injection 

Nursing management :-

  • Pain related to fracture
  • Altered nutrition less then body requirement related to calcium and vitamin D deficiency
  • Risk of fracture due to disease condition softening of bone
  • Impaired physical activity due to disease condition.


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