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Osteomalacia mimicking spondyloarthropathy: a case report


Osteomalacia is a metabolic bone disorder characterized by impaired mineralization of bone matrix. Symptoms of osteomalacia can be confused with other conditions such as spondyloarthropathy, polymyalgia rheumatica, polymyositis, and fibromyalgia. In this case, we report a patient with axial osteomalacia who developed low back pain, morning stiffness, and “grade 3 sacroiliitis” in pelvis X-ray, leading to the misdiagnosis as seronegative spondyloarthropathy. Serum biochemical studies revealed low serum phosphorus, low 25-hydroxy vitamin D3, normal calcium, elevated parathyroid hormone, and alkaline phosphatase levels. Her symptoms were relieved with vitamin D and calcium therapy. The diagnosis of osteomalacia should be considered in case of sacroiliitis and spondylitis.

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  1. Demirbilek H, Aydoğdu D, Ozön A (2012) Vitamin D-deficient rickets mimicking ankylosing spondylitis in an adolescent girl. Turk J Pediatr 54:177–179

    PubMed  Google Scholar 

  2. El Mahou S, Moineuse C, Navaux F, Cantagrel A, Mazieres B, Laroche M (2003) Osteomalacia and sacroiliitis. Joint Bone Spine 70:310–312

    PubMed  Article  Google Scholar 

  3. Jacobson JA, Kalume-Brigido M (2006) Case 97: X-linked hypophosphatemic osteomalacia with insufficiency fracture. Radiology 240:607–610

    PubMed  Article  Google Scholar 

  4. Gifre L, Peris P, Monegal A, Martinez de Osaba MJ, Alvarez L, Guañabens N (2011) Osteomalacia revisited: a report on 28 cases. Clin Rheumatol 30:639–645

    PubMed  Article  Google Scholar 

  5. Bhan A, Rao AD, Rao DS (2010) Osteomalacia as a result of vitamin D deficiency. Endocrinol Metab Clin North Am 39:321–331

    CAS  PubMed  Article  Google Scholar 

  6. Fok AW, Ng TP (2010) Osteomalacia: a case series of patients with atypical clinical orthopaedic presentations. Fok AW, Ng TP. Hong Kong Med J 16:476–479

    CAS  PubMed  Google Scholar 

  7. Thacher TD, Clarke BL (2011) Vitamin D insufficiency. Mayo Clin Proc 86:50–60

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  8. Reginato AJ, Falasca GF, Pappu R, McKnight B, Agha A (1999) Musculoskeletal manifestations of osteomalacia: report of 26 cases and literature review. Semin Arthritis Rheum 28:287–304

    CAS  PubMed  Article  Google Scholar 

  9. Akkus S, Tamer MN, Yorgancigil H (2001) A case of osteomalacia mimicking ankylosing spondylitis. Rheumatol Int 20:239–242

    CAS  PubMed  Article  Google Scholar 

  10. Onur O, Celiker R, Cetin A, Alikaşifoğlu A, Uğur O, Başgöze O (1997) Hypophosphatemic rickets with sacroiliitis-like presentation in an adolescent. Scand J Rheumatol 26:332–335

    CAS  PubMed  Article  Google Scholar 

  11. Gupta AD (2009) Sacroiliac joint pathologies in low back pain. J Back Musculoskelet Rehabil 22:91–97

    PubMed  Google Scholar 

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Correspondence to Y. Garip.

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Garip, Y., Dedeoglu, M. & Bodur, H. Osteomalacia mimicking spondyloarthropathy: a case report. Osteoporos Int 25, 1983–1985 (2014).

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  • Osteomalacia
  • Sacroiliitis
  • Spondyloarthritis
  • Vitamin D deficiency