What is osteomalacia and what are its causes and symptoms
Osteomalacia is a disease involving softening of the bones. Pathology occurs due to violation of mineralization of bone structures. The disease is similar to rickets in children, which appears due to lack of vitamin D3.
In this pathology in children, there is softening of the fontanels of the skull. The head becomes soft and deformed.
Symptoms in adults
The disruption of mineralization occurs in women 10 times more often than representatives of a strong half of mankind. Doctors there are 4 clinical forms of the disease depending on time of occurrence:
- rachitic (in puberty);
Perlina stage of disease is manifested by softening of the structure of the vertebrae. Pathology leads to a curvature of the spine with displacement in the lateral plane and the flattening of the physiological lordosis and Koposov.
Rachitic pathology form appears at puberty. The reason for its formation is the lack of nutrients and blood supply.
Menopausal shape appears in women during menopause. In this phase there is a lack of estrogens, therefore, disrupted the process of osteogenesis.
Senile osteomalacia is formed due to multiple defects in metabolic exchange. On the background of degenerative conditions and disorders of microcirculation is formed by the change of calcium metabolism. If the mineral is poorly absorbed through the gastrointestinal tract, increases the process of destruction of bone tissue.
Rachitic form of the disease characterized by symptoms similar to rickets in children. When there is curvature of lower and upper extremities, spine, skull.
The Symptoms of rachitic form:
- knee joints depart outwards when closed heels;
- funnel chest
- lateral curvature of the spine;
- kyphosis of the thoracic spine;
- muscle spasm of the adductors of the lower limbs
- walk small steps.
The symptoms described Above are formed at an early age (before puberty).
Menopausal osteomalacia is manifested by a shortening and kyphosis of the lumbar spine. This decreases the growth of women. In medicine, the appearance of women with osteomalacia menopause is called "sitting dwarf". This description pinpoints the symptoms of the disease, thereby reducing the growth of women in a sitting position.
In Addition to "sitting dwarf" climacteric symptoms osteomalacia accompanied with multiple fractures. Fragile bone structure due to the lack of minerals in excessive stretching of limbs or a strong impact, quickly collapses.
An Additional symptom – "punctuating the walk". The woman with the disease is very difficult to climb the stairs. Because of the increased sensitivity of tissues at the lack of calcium any irritation of the skin accompanied by severe pain.
Painful sensations arise when digital examination palpation of the iliac crests. The syndrome of latent tetany creates problems when walking. During the Commission of movements cramps of the lower extremities, in which any attempt at walking causes the pain.
Symptoms in children
The Symptoms of osteomalacia in children:
- the Presence of zones of adjustment Looser – sections decrease bone density.
- the Syndrome Milkman – insufficient calcium in the bones.
- Symptom Renoir – radiologic manifestations of decalcification of bones.
- deformity of the pelvis according to the "ACE of hearts" – the flattening of the downward and the upward extension.
Zone Lootera – specific symptoms, which are characterized by limited sections of the enlightenment, which in the picture appear in the form of small strips, wedges and cracks. These formations are identified mostly in the femoral neck, pubic bone, a small tibia and fibula.
The Greatest value in the diagnosis of disease are laboratory tests that detect increased levels of alkaline phosphatase. This marker indicates increased activity of osteoclasts (cells-destroyers of bone tissue).
What laboratory criteria help to determine osteomalacia:
- the content of phosphorus and calcium in the blood;
- alkaline phosphatase
- elevation of liver enzymes (AST, Alt).
The Most reliable diagnostic symptom of this disease is a biopsy of bone tissue in the zones Looser. To conduct the study can be carried out examination of the pelvic bone under local anesthesia. After the biopsy of the scallop is assigned to the vitamin D for restoring bone structure.
Why soften the bone structure
Clinical studies regarding the softening of the bones showed that the pathology relates to the number of generalized. Specific changes to mineral metabolism are observed in all tissues, but the preferential localization of pathological changes – bones.
Experiments have not led to the installation of the causes of disease. Main etiologicalfactors soften the bone structure:
- nutritional factors a deficiency of vitamin D, calcium salts, phosphoric acid. In medical practice there are cases when osteoporotic changes are observed on the background diet;
- degenerative diseases – a violation of proceeds of nutrients and lack of circulation;
- low concentration of calcium and vitamin D3
- changes in hormonal status.
The Pathogenesis of the disease is accompanied by the substitution of osteoid tissue of bone structures. The osteoid bone structure undergoing calcification due to excessive deposition of calcium salts. Osteoid appears in cases when the body lacks of vitamin D. Against this background, the observed multiple resorptive changes throughout the body.
There are several forms of osteoid:
- in pregnancy.
Youth osteomalacia is manifested by calcifications of the spine. On the backdrop of the active proliferation of cartilage observed salt deposits Ca. Most actively these changes are visible in adolescence. In children, the osteoid is observed less frequently.
Senile form of the disease is characterized by multiple foci of accumulation of bone tissue in all organs and tissues. Osteomalacia accompanied with multiple changes of the ribs and chest.
During pregnancy, the pelvic bones are softened and deformed pelvis. When childbearing is a significant concentration of calcium and vitamin D are spent on the growth and development of the baby. Against this background, the mother observed a softening of the bone structure. To prevent the pathological process pregnant women are prescribed calcium supplements.
Paritala osteomalacia characteristic of women who carries the child, at the age of 20-40 years. It manifests itself not only during pregnancy but also during breastfeeding. Patients complain of pain in the pelvis and sacrum. Over time, they have a "duck walk".
There is the concept of osteomalaciei the pelvis, which is characterized by a pronounced narrowing at the bottom. When it is impossible through the natural childbirth way. In such a situation, births are performed by cesarean section.
In conclusion, we should say that the above symptoms in children can be quickly treated. With timely administration of these drugs can prevent complications in the organs and tissues.