Part of “CHAPTER 63 – OSTEOMALACIA AND RICKETS“

Sometimes patients with osteomalacia have no symptoms, so that the diagnosis is not readily apparent early in the course of the disease. When present, symptoms include diffuse skeletal pain and muscle weakness. The pain often is described as dull and aching and is worsened by activity. It is present in the lower back and hips or at sites where fractures have taken place. Bone tenderness may be present on palpation. Fractures most commonly occur in the ribs, vertebrae, and long bones, and may lead to skeletal deformities. Muscle weakness, often present in patients with osteomalacia, may be severe and associated with wasting.5 Because weakness usually involves the proximal muscle groups, particularly of the lower extremities, it may contribute to the characteristic waddling gait.