Rickets and Osteomalacia: Pathogenesis and Clinical Findings • Calcification inhibitors (excess exposure to A1, Fluoride, etidronate) • Lack, or reduced function, of mineralization enzymes (like ALP) • Lack of bone mineral components: 1. Phosphate: renal tubule disorders, vit D or Phosphate deficiency, Incr FGF23 2. Calcium: severe deficiency (infants) • Abnormal Vitamin D Metabolism: Deficiency, hereditary disorders of synthesis or vitamin D receptor => Bone mineralization defect (Osteopenia with reduced mineralization) • Rickets: Occurs before epiphyseal closure • Osteomalacia: Occurs after epiphyseal closure => • Short stature • Diffuse skeletal pain (bone tenderness) • Bowed legs • Fractures • Proximal muscle, weakness manifesting often as gait disturbances #Rickets #Osteomalacia #pathophysiology #diagnosis #signs #symptoms
