Softening of bone tissue as a consequence of osteomalacia.

Atrophy bone tissue There are two types - osteoporosis (fragility, brittle bones) and osteomalacia (softening of bones). In both cases there is a lack mineral salts, which, especially calcium phosphate, give bones hardness and strength. When bone tissue atrophies, the structure of the bones changes and the risk of fractures increases sharply.

Symptoms

Spontaneous bone pain, pain on percussion.
Backache.
Often no symptoms.

Causes

The structure of bone tissue depends on nutrition, physical activity and genetic factors. Nutrition for children and adolescents is especially important, because... during this period it is formed bone structure. The cause of osteomalacia is a lack of vitamin D. This vitamin is necessary for the body to properly absorb calcium from food. Deficiency of this vitamin leads to progressive decalcification of bone tissue. Vitamin D deficiency can occur due to poor diet and insufficient sun exposure. Vitamin D deficiency may occur when renal failure and diseases of the digestive tract.

The causes of osteoporosis are not entirely clear. It often begins in women after menopause and is associated with hormonal changes, occurring in a woman’s body. Osteoporosis can be caused by a sedentary lifestyle, prolonged bed rest, and prolonged use of glucocorticoids. Other causes of bone atrophy are osteomyelitis, bone tuberculosis and infectious diseases joints.

Treatment

In the treatment of osteomalacia, vitamin D is primarily prescribed, but caution must be exercised since an overdose of the vitamin poses a health hazard. Vitamin D also helps with osteoporosis. Salmon calcitonin has a positive effect. Estrogens are used to treat postmenopausal osteoporosis in women.

It is important to eat foods containing many vitamins and minerals. Additionally, you can take calcium and magnesium supplements. Regular physical activity is required.

Osteoporosis is often diagnosed by accident. Bone examination is usually done when a fracture occurs. Osteomalacia in children manifests itself as rickets. The muscles are flaccid and weak. Today, many children are prescribed vitamin D for the treatment and prevention of rickets.

The doctor will take an interest in the patient’s lifestyle and find out if there are any relatives with this disease. He will take an x-ray and a bone biopsy. Using computed tomography or ultrasound, bone density is determined.

Course of the disease

Only 10-20% of patients are diagnosed and treated for osteoporosis in a timely manner. In most cases the pathology for a long time is practically asymptomatic. On initial stages There are no obvious changes on x-rays either. Bones gradually thin out and become porous, increasing the likelihood of fractures. A femoral neck fracture is a common injury in osteoporosis in older people. Spontaneous vertebral fractures are common.

Osteoporosis most often affects postmenopausal women. The progression of the disease can be stopped by the use of a combination of estrogens and gestagens. These hormones are used both for the prevention of osteoporosis and for its treatment.

Description:

Osteomalacia (lat. osteomalacia from ancient Greek ὀστέον - bone + μαλακία - softness - softening of bones) is a systemic disease characterized by insufficient mineralization of bone tissue.

Symptoms:

Osteomalacia is an adult. The disease occurs in women approximately 10 times more often than in men. Depending on the time of appearance, 4 forms are distinguished:
a) late rickets during puberty;
b) puerperal osteomalacia (observed very rarely and for the most part localized only in the spine);
c) menopausal osteomalacia;
d) senile osteomalacia.

In addition, age-independent excretory osteomalacia occurs with pathological discharge calcium due to long-term kidney disease.
With all 4 forms of osteomalacia, the leading symptom may be vague pain in the back and hips, less often pain is felt in the shoulder and chest. At the onset of the disease, noticeable skeletal deformations, so characteristic of severe cases, are absent. Nevertheless, with late rickets, minor curvatures of the legs can be detected early: with the feet closed, they move away by several centimeters knee joints, and with closed knees - feet (Wernly) or beginning funnel-shaped deformation chest. With climacteric osteomalacia, kyphosis is especially noteworthy, the lumbar region seems shortened, and in advanced cases, a shortening of body length is actually observed. Since only the torso is shortened, the picture of a sedentary dwarf appears (as opposed to a sedentary giant in chondrodystrophy). Only in rare cases does it come to further curvature of the skeleton, which, combined with soreness of the bones, leads to a complete loss of mobility.

With senile osteomalacia, changes in the pelvis recede into the background, but much more often than with menopausal osteomalacia, multiple fractures are often observed. While in mild cases walking is not impaired, in moderate cases a waddling gait (alternating tilts of the upper half of the body to the right and left) is typical. There is also a gait in small steps (“marche a petits pas”), as in parkinsonism. Walking up stairs and steps is especially difficult (Wernly). The sensitivity of bones to pressure is expressed very early. Pain is caused by lateral compression of the scallops iliac bones, and when the compression of the pelvis, which is compressed by several millimeters, ceases. You should pay attention to spasm of the leg adductors. A frequent accompanying phenomenon is hidden. In typical cases, a large diagnostic value belongs to the x-ray picture.

Osteomalacia of bones is characterized by depletion of calcium salts, bone curvatures and the presence of zones of Looser restructuring (Milkman syndrome).
A blurred outline is typical and may give the impression that the device is not clearly positioned. We can talk in these cases about the “Renoir aspect”. By itself, of course, it is not yet evidence for osteomalacia. However, decalcification is not always recognized radiographically.
Of the bone curvatures, the deformation of the pelvis in the form of an “ace of hearts”, which is often more clearly expressed on the anatomical specimen, is especially characteristic of osteomalacia.
Looser's rearrangement zones can be said to be pathognomonic for osteomalacia, which are characterized by vaguely limited clearing of bone shadows in the form of strips, cracks or wedges, most often observed in the branches of the pubic bones, in the femoral neck, tibia, humerus, small tibia and in the ribs.
Of the laboratory data, the greatest diagnostic value is an increase in alkaline phosphatase (normally 3 units), indicating increased activity osteoblasts. The content of calcium (normally 9.5-11 mg%) and phosphorus (normally inorganic phosphates is 2.7-3.7 mg%), as a rule, is slightly reduced. According to Albright, a decrease in the content of calcium salts and phosphoric acid.
In unclear cases, bone biopsy should be resorted to. The only absolutely reliable diagnostic sign is the detection of an osteoid border (Schiipbach, Wernly). A pelvic bone scallop biopsy can be performed without any difficulty by any surgeon under local anesthesia.
Finally, with diagnostic purpose the results of a trial of vitamin D therapy can also be used (from 3 to 6 loading doses 600,000 units per oil solution intramuscularly for 3-6 weeks).

Causes:

It may be due to a lack of vitamin D, a violation of its metabolism, as well as a deficiency of macro- and microelements caused by their increased filtration in the kidneys or impaired absorption in the intestines. With osteomalacia it increases overall volume bone substance, but its mineralization decreases.

Treatment:

For treatment the following is prescribed:

Treatment is usually conservative. It includes the administration of vitamin D, calcium, phosphorus supplements, restorative therapy, UV irradiation, therapeutic exercises and massage. When severe deformities of the limbs develop, surgical treatment is combined with a set of measures aimed at normalizing mineral metabolism. Deformation of the pelvic bones during pregnancy is an indication for caesarean section. As osteomalacia progresses during lactation, they switch to artificial feeding.
Prognosis for life with timely treatment favorable.

Osteomalacia: what is it? The disease is a disorder of bone tissue mineralization. As a result, the bones soften, they become brittle and susceptible to various kinds injuries and damage. The clinical picture of the disease resembles rickets in children, which appears due to a lack of vitamin D3. This system process, because all the bones in the body soften. Previously, this disease was quite rare. However, at present, due to the current modern life every tenth person suffers from this disease. In most cases, mineralization of bone tissue is observed in women, sometimes osteomalacia occurs in animals.

Classification of the disease

This pathology is divided into many types, the nature of which depends on certain factors. On this moment The following types of osteomalacia are distinguished:

1) Depending on the course of the disease:

deficiency, that is, hypovitaminosis;
vitamin-resistant, occurs due to damage to the intestines or kidneys.

2) Depending on chemical element who participates in the exchange:

phosphopenic;
calcipenic.

3) Depending on the gender and age of the patient:

puerperal (osteomalacia in pregnant women);
senile (occurs due to age-related changes);
juvenile (appears during puberty);
menopausal.

Causes of the disease

To understand why this disease appears and what precedes it, it was carried out great amount research. Scientists are perplexed as to why bones become soft and osteomalacia develops. As a result of many experiments, experts found that the pathology is generalized. In other words, this means that it is formed throughout the body. In most cases, the lesion is located in the bones. Today, doctors find it difficult to name specific reasons.

However, the research was not in vain, and it was possible to find out what factors influence this process. So, they highlight following reasons osteomalacia:

changes in hormonal levels;
lack of vitamin D3 and calcium in the body;
dystrophic diseases.

These factors are activators for the progression of the disease. It is worth remembering that the earlier the disease is detected, the easier it will be to cure it.

What influences the development of pathology?

Osteomalacia: what is it? As already noted, the disease is associated with softening of the bones. For many years, the best scientists have tried to figure out what causes the disease? As a result of research, certain reasons were identified. In more than 60% of patients, no metabolic abnormalities were found, and in childhood was in the body sufficient quantity vitamin D. However, by the age of 30-40, each of them was diagnosed with mineralization of bone tissue. This suggests that the roots of osteomalacia are buried in a genetic trait.

Scientists have also found out what matters hormonal background. After all, softening of bones occurs more often in women than in men. In addition, it is worth noting that most patients in one way or another belong to representatives of specific professions. This means working in chemical plants, living in an environmentally unfavorable area, etc.

Signs of osteomalacia

There are two ways of developing the disease: asymptomatic and with the manifestation of certain symptoms. In the first case, the disease is detected on x-ray, most often by accident. But there are situations when the symptoms of osteomalacia are quite pronounced.

Distinguish following signs diseases:

constant, unrelenting pain. Patients most often complain about painful sensations in the heels, knees, ribs, pelvis, lower back. Moreover unpleasant feelings occur both under certain types of loads and when pressure is applied to the bone;
flashes of severe pain. Due to the fact that bones become brittle, even light load on the musculoskeletal system can lead to fracture or deformation. It causes severe pain, which can pass quickly and soon recur;
muscle weakness. Hypovitaminosis leads to impairment muscle functions. As a result, the patient experiences instability while walking, poor coordination of movements, and other cases associated with muscle weakness.

Diagnostics

Osteomalacia syndrome is diagnosed based on the patient's complaints, medical history, external examination and research results. If the disease is in the initial stages, it is quite easy to identify it. The patient undergoes standard procedures, after which the doctor makes an accurate diagnosis.

When long term disease, the specialist will need more data about the patient. In order not to be mistaken in identifying the disease, the doctor asks the patient to undergo additional procedures. Most often this is an ECG, ultrasonography etc. It is important to note that osteomalacia in half of the cases is accompanied by osteoporosis. It is characterized by multiple fractures. Therefore, the doctor must conduct studies based on an assessment of bone tissue density.

Possible complications

It is worth noting that osteomalacia is very serious illness, and ignoring this disease can lead to negative consequences. Delayed diagnosis negatively affects not only the functioning of the musculoskeletal system, but also the body as a whole.

Osteomalacia: the process of death of old cells, which, among other things, is an obstacle to the mineralization of new cells. Thus, all bone tissue becomes “soft”, which leads to significant deformations of the skeleton. This, in turn, affects the internal vital organs. As a result of deformations of the chest and pelvis, very serious problems With bladder, heart, lungs, intestines, etc.

Therapy

Once specialists have discovered osteomalacia in a patient, the treatment process begins. Of course, before prescribing a course of therapy, you should first understand the reasons. If doctors can identify them, it will be big victory. Then the treatment of osteomalacia will be aimed at eliminating the factors that were activators of the disease.

Therapy is prescribed not by one doctor, but by a group of specialists. For this, a gastroenterologist, surgeon, orthopedist, etc. are involved. Sometimes ten or more different doctors are brought together for correct treatment so that the methods are most effective. When prescribing therapy, we must not forget about complications that can arise at any time. Therefore, the patient is recommended to visit several more specialized specialists, such as a cardiologist, neurologist or pulmonologist. Such a collaboration of doctors is able to prescribe the most effective method treatment.

With the help of medications

After osteomalacia is detected, specialists choose a method of therapy. There are two methods: medication and surgery. The latter is used in limited cases. As for treatment with drugs, it consists mainly of injections of vitamin D. Large doses are initially administered, gradually decreasing them during the treatment. In addition, doctors often prescribe oral vitamins B and C.

The fact is that they have an indirect effect on phosphorus and calcium metabolism, and also normalize the work nervous system. This is especially effective when muscle weakness caused by osteomalacia. Vitamins B and C are aimed at enhancing the activity of vitamin D. It is worth noting that treatment should be carried out under the strict supervision of the attending physician. This is due to the fact that taking medications requires constant monitoring of urine and blood parameters and, if necessary, dose changes.

Surgical intervention

As already noted, this method is used in limited cases. It is used for the following conditions:

when bone deformations disrupt the functioning of internal vitals important organs. In this case, doctors use vertebroplasty. It consists of strengthening the vertebrae using medical cement and polymers. Sometimes rib fixation is used and pelvic bones special designs;
multiple fractures accompanied by slow healing. Then doctors recommend the introduction of a medical structure that will fix the bone in the correct position. This design is placed during fusion and consists of metal or polymer.

In any case, such decisions are made by the doctor with the consent of the patient.

How does a diagnosis of osteomalacia affect your lifestyle?

The symptoms and treatment of osteomalacia have a profound impact on the patient's life. He will need to completely reconsider his usual existence, as well as make changes to his diet.

So, some advice from experts:

The first step is to replace the regular bed and mattress with orthopedic ones. It is desirable that there be provisions different zones rigidity for proper distribution of body weight. Since softening of the bones can lead to problems with the spine, this requirement cannot be ignored. You also need to create your daily routine so that you have time for proper rest;
if the work requires being in a static position for a long time, then you need to get up and do a warm-up at least once an hour. It will be enough to walk around the office for a few minutes or climb one flight of stairs;
it is important to comply drinking regime. This requirement is especially relevant if osteomalacia is accompanied by osteoporosis. It must be remembered that the volume of all liquid should not exceed 2 liters per day. The attending physician will advise correct mode drinking, and must be adhered to;
if the patient overweight, you need to try with all your might to get rid of it. Reducing body weight helps reduce stress on the bones.

Conclusion

Osteomalacia: what is it? In this article we looked at this concept. This is a disease characterized by impaired mineralization of bone tissue. As a result of this impact, the bones soften, which leads to unpleasant consequences.

After detecting a pathology, it is necessary to follow the doctor’s recommendations. As practice shows, in disciplined patients the development of osteomalacia stops and the pain disappears. In some cases, it is possible to cure anatomical defects. Therefore, to get rid of this disease, you need to strictly monitor your health and listen to your doctor.

Osteomalacia is systemic disease bone tissue, which makes bones flexible. In other words, bone softening occurs. This pathology occurs in people with a mature skeleton. Osteomalacia occurs due to vitamin D deficiency, disturbances in its metabolism, as well as a lack of certain macro and microelements. Studies have shown that osteomalacia affects all tissues, but the bones suffer the most. Osteomalacia is a similar disease to rickets in newborns.

Causes

The disease can occur in a child when his bone skeleton is fully formed. The main cause of osteomalacia in a child is vitamin D deficiency. Until now unknown exact reason development of vitamin D deficiency in children's body. Experts identify several factors that can lead to osteomalacia:

Poor nutrition with a lack of beneficial micro and macroelements.
Development of degenerative-dystrophic diseases.
Changes in hormonal metabolism.
Insufficient exposure to sunlight.

Symptoms

Parents can recognize the disease in a child by certain signs:

Most often in children, osteomalacia manifests itself in the form of damage to the bones of the extremities.
IN adolescence problems with the spine arise.
The child experiences pain. Most often they appear in the arms and legs.
With the development of osteomalacia, curvature of the legs is observed. The legs of a child with a vitamin D metabolic disorder take on a shape resembling the letter “O”.
It is difficult for the child to move.

Diagnosis of osteomalacia in a child

A doctor will be able to diagnose the pathology during an external examination of the child. Parents should contact an orthopedist and endocrinologist.

For determining accurate diagnosis are appointed laboratory research. The child must undergo blood and urine tests. With osteomalacia, there is an increase in the level alkaline phosphatase. This indicator indicates what is happening in the child’s body increased activity cells that destroy bone tissue - osteoclasts. Attention is paid to the level of phosphorus and calcium in the blood. When osteomalacia occurs in a child, the level of liver enzymes. Most precise research When making a diagnosis, a bone tissue biopsy is performed. The procedure is performed using local anesthesia.

An x-ray may be ordered.

Complications

Many parents worry about how dangerous the disease is for their child? The disease can cause complications if timely treatment is not started.

If the diagnosis and treatment of osteomalacia in a child were started on time, it is possible to avoid dangerous consequences and complications.
In advanced cases, bone deformation occurs. This leads to disability of the baby.
Without treatment, displacement and deformation begin internal organs, which manifests itself in the form of serious disruptions to the functioning of the body.
If left untreated, these complications can be fatal.

Treatment

What can you do

Parents cannot treat the disease on their own. When the doctor prescribes treatment, parents must adhere to it.

Proper and nutritious nutrition is of great importance in the treatment of osteomalacia in a child. The diet of a child with bone tissue pathology should contain foods with high content calcium and vitamin D. The baby should be fed frequently, but in small portions. IN children's menu You should include fresh vegetables and fruits, herbs, fermented milk and dairy products, wheat bread, steamed meat and fish, and hard cheeses. With osteomalacia, it is necessary to limit salt intake in the child’s diet. Meat should be consumed in small quantities.

The child should not drink strong tea, coffee, carbonated and energetic drinks. Doctors advise consuming cheeses and other dairy products in evening time days. During this period, calcium absorption occurs more efficiently.

What does a doctor do

To cure osteomalacia in a child, it is necessary to eliminate the deficiency of vitamin D, calcium and phosphorus. Until the deficiency of these substances is replenished, bone tissue pathology cannot be cured. The doctor prescribes vitamin D, calcium and phosphorus in the form of vitamin complexes.

Some medications are prescribed intramuscularly. Vitamin D3 can be prescribed in the form of drops. In addition to taking vitamin D, vitamins C and B are needed. They help in the absorption of vitamin D3, which increases the effectiveness of treatment.

The doctor prescribes therapeutic exercises, massage and ultraviolet irradiation. Treatment for osteomalacia usually lasts for a long time.

If a child has bone deformation, surgical intervention is performed.

Prevention

To prevent the development of pathology in a child, it is necessary to adhere to preventive measures:

Parents should monitor the baby’s diet and daily routine so that he does not develop bone tissue damage. Nutritious food is an excellent method of preventing osteomalacia in a child. Children's diets should contain foods high in calcium, phosphorus, and vitamin D. Also important are foods with vitamin C and B vitamins, which help in the absorption of vitamin D3.
Taking vitamin D also helps prevent illness. But taking vitamin complexes should occur after consultation with a doctor.
Parents should help their child in timely treatment of diseases gastrointestinal tract and other chronic diseases.
The child should be in the fresh air every day.
Parents should ensure that the child avoids stressful situations.
The child must have a daily routine that he should follow.

You will also learn how untimely treatment of osteomalacia in children can be dangerous, and why it is so important to avoid the consequences. All about how to prevent osteomalacia in children and prevent complications.

A caring parents will be found on the service pages full information about the symptoms of osteomalacia in children. How do the signs of the disease in children aged 1, 2 and 3 differ from the manifestations of the disease in children aged 4, 5, 6 and 7? What is the best way to treat osteomalacia in children?

Take care of the health of your loved ones and stay in good shape!

The bone tissue of the body is the basis of the human skeleton and is a depot of mineral salts. Bone tissue takes part in metabolism, so metabolic disorders affect the condition of human bones. Osteomalacia is one of the metabolic syndromes, which is characterized by impaired mineralization of the formed bone matrix in adults. Similar metabolic disorders in children's bodies are called rickets. Despite the fact that osteomalacia affects the bones, this disease is an endocrinological pathology.

Why does osteomalacia syndrome occur and how does it manifest?

Osteomalacia of bones is a systemic pathology characterized by impaired mineral metabolism with damage to bone tissue. The word “osteomalacia” itself means “softening of the bones,” which explains the nature of the pathology. As a result of a lack of vitamins, calcium salts and phosphoric acid in the patient’s body, bones become softened and deformed, becoming overly flexible. Similar condition except characteristic symptoms, worsening the patient’s quality of life, threatens the development of serious complications, so the pathology requires timely detection and effective treatment.

Osteomalacia of bones:

classification of osteomalacia bone syndrome: main forms;
etiology of osteomalacia bone syndrome: common causes;
clinical picture of osteomalacia bone syndrome.

Classification of osteomalacia bone syndrome: main forms

Osteomalacia of bones occurs almost 10 times more often in females. Depending on when the first signs of the disease appear in the human body, osteomalacia is classified as follows:

childhood and juvenile forms of osteomalacia - characterized by a predominant lesion pathological process limb bones;
menopausal and senile forms - characterized by damage to the vertebrae, which leads to shortening of the body and kyphosis;
puerperal osteomalacia – develops in pregnant women and is characterized by damage to the pelvic bones, lower sections spine and upper sections femurs.

Etiology of osteomalacia bone syndrome: common causes

Depending on the etiological factors osteomalacia of bones is divided into two large groups: osteomalacia, which develops as a result of impaired mineralization and osteomalacia, which occurs against the background of secondary hyperparathyroidism and hypophosphatemia. The following reasons for the development of osteomalacia in these cases are identified:

osteomalacia against the background of secondary hyperparathyroidism and hypophosphatemia can occur as a result of a deficiency in the consumption and absorption of vitamin D or loss of proteins that bind it, impaired 25-hydroxylation, as well as pathology of the response of target organs to calcitriol;
The development of osteomalacia can be caused by such mineralization defects as: pathologies of the bone matrix, hypophosphatasia, taking mineralization inhibitors, phosphate deficiency, as well as defects in renal reabsorption.

Clinical picture of osteomalacia bone syndrome

The clinical picture of osteomalacia bone syndrome includes symptoms characteristic of a lesion by a pathological process musculoskeletal system. Patients may complain of muscle weakness, which occurs predominantly in the proximal limbs and is associated with muscle atrophy. As a result of this, patients experience significant discomfort when moving and they develop the so-called “ duck walk" Patients are also concerned about the appearance of bone pain, which is more pronounced in the lumbosacral region, pelvic bones and lower limbs. The pain is dull, aching in nature, and intensifies with movement. A characteristic feature and at the same time, a complication of osteomalacia syndrome is the occurrence of fractures. Noteworthy is the fact that fractures can occur even with minor injuries or without injury as such. With prolonged severe course Osteomalacia in adults causes skeletal deformities.