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Osteomalacia

A defect in the mineralization of the bony matrix.

Associated with bone pain, pseudofractures and deformities with elevated alkaline phosphatase, normal calcium and phosphate levels.

Long standing hypophosphatemia and hypocalcemia lead to impairment of mineralizaton of the bone matrix.

Associated with a marked impairment in bone resorption secondary to the fact that most of the mineralized bone is covered with unmineralized osteoid, which cannot be resorbed by osteoclasts.

Typical radiographic findings are pseudofractures correlating with areas of bone that are unmineralized.

Adult osteomalacia can manifest on skeletal imaging as pseudo-fractures, insufficiency fractures or hot spots on bone scans mimicking metastatic cancer.

Can result in low bone mineral density readings.

Conditions such as hypophosphatemia that lead to osteomalacia in adults can lead to rickets if present during skeletal growth.

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