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Osteomalacia and Rickets

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Orthopedic Surgery Clerkship

Abstract

Osteomalacia and rickets are disorders characterized by decreased or defective mineralization of the bone. In osteomalacia, there is reduced mineralization of the osteoid at the site of bone turnover, while in rickets, there is reduced mineralization at the epiphyseal growth plates. These can occur simultaneously, but once the growth plates have fused, only osteomalacia can occur. The various etiologies result in hypocalcemia, hypophosphatemia, and/or a direct inhibition of the mineralization of the bone. This review will investigate the various etiologies, presentations, diagnostics, and treatments for osteomalacia and rickets.

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References

  1. Gallagher J. Vitamin D insufficiency and deficiency. In: The American Society for Bone and Mineral Research. Primer on the metabolic bone disease and disorders of mineral metabolism. 8th ed. Ames: Wiley-Blackwell; 2013. p. 624–631.

    Google Scholar 

  2. Kapelari K, Köhle J, Kotzot D, Högler W. Iron supplementation associated with loss of phenotype in autosomal dominant hypophosphatemic rickets. J Clin Endocrinol Metabol. 2015;100(9):3388–92.

    Article  CAS  Google Scholar 

  3. Ruppe M, Jan de Beur S. Disorders of phosphate homeostasis. In:The American Society for Bone and Mineral Research. Primer on the metabolic bone disease and disorders of mineral metabolism. 8th ed. Ames: Wiley-Blackwell; 2013. p. 601–12.

    Chapter  Google Scholar 

  4. Greenspan F, Gardner D, Shoback D. Basic & clinical endocrinology. New York: McGraw-Hill; 2011.

    Google Scholar 

  5. Gasque K, Foster B, Kuss P, Yadav M, Liu J, Kiffer-Moreira T, et al. Improvement of the skeletal and dental hypophosphatasia phenotype in Alpl−/− mice by administration of soluble (non-targeted) chimeric alkaline phosphatase. Bone. 2015;72:137–47.

    Article  CAS  PubMed  Google Scholar 

  6. Frame B, Parafitt A. Osteomalacia: current concepts. Ann Intern Med. 1978;89(6):966–82.

    Article  CAS  PubMed  Google Scholar 

  7. Drezner M. Tumor-induced osteomalacia. Rev Endocr Metab Disord. 2001;2:175–86.

    Article  CAS  PubMed  Google Scholar 

  8. Reginato AJ, Coquia JA. Musculoskeletal manifestations of osteomalacia and rickets. Best Pract Res Clin Rheumatol. 2003;17(6):1063–80.

    Google Scholar 

  9. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016;101(2):394–415.

    Google Scholar 

  10. Rabelink N, Westgeest H, Bravenboer N, Jacobs M, Lips P. Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease. Arch Osteoporos. 2011;6(1–2):209–13.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chong W, Andreopoulou P, Chen C, Reynolds J, Guthrie L, Kelly M, et al. Tumor localization and biochemical response to cure in tumor-induced osteomalacia. J Bone Miner Res. 2013;28(6):1386–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Balvers MG, Brouwer-Brolsma EM, Endenburg S, de Groot LC, Kok FJ, Gunnewiek JK. Recommended intakes of vitamin D to optimise health, associated circulating 25-hydroxyvitamin D concentrations, and dosing regimens to treat deficiency: workshop report and overview of current literature. J Nutr Sci. 2015;4(e23):1–8.

    Google Scholar 

  13. Basha B, Rao D, Han Z, Parfitt A. Osteomalacia due to vitamin D depletion: a neglected consequence of intestinal malabsorption. Am J Med. 2000;108(4):296–300.

    Article  CAS  PubMed  Google Scholar 

  14. Carpenter T, Imel E, Holm I, Jan de Beur S, Insogna K. A clinician’s guide to X-linked hypophosphatemia. J Bone Miner Res. 2011;26(7):1381–8.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Econs M, McEnery P. Autosomal dominant hypophosphatemic rickets/osteomalacia: clinical characterization of a novel renal phosphate-wasting disorder. J Clin Endocrinol Metabol. 1997;82(2):674–81.

    Article  CAS  Google Scholar 

  16. Joiner T, Foster C, Shope T. The many faces of vitamin D deficiency rickets. Pediatr Rev. 2000;21(9):296–302.

    Article  CAS  PubMed  Google Scholar 

  17. Balsan S, Garabédian M, Larchet M, Gorski A, Cournot G, Tau C, et al. Long-term nocturnal calcium infusions can cure rickets and promote normal mineralization in hereditary resistance to 1,25-dihydroxyvitamin D. J Clin Investig. 1986;77(5):1661–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Lorenz-Depiereux B, Benet-Pages A, Eckstein G, Tenenbaum-Rakover Y, Wagenstaller J, Tiosano D, et al. Hereditary hypophosphatemic rickets with hypercalciuria is caused by mutations in the sodium-phosphate cotransporter gene SLC34A3. Am J Hum Genet. 2006;78(2):193–201.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Regenerative Medicine, Orthopaedic Surgery, Medical College of Georgia, CA 1004 1120 15th Street, Augusta, GA, USA

    Christopher Treager & Carlos Isales

Authors
  1. Christopher Treager
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  2. Carlos Isales
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Correspondence to Carlos Isales .

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Editors and Affiliations

  1. Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA

    Adam E. M. Eltorai

  2. Department of Orthopedic Surgery, Division of Pediatric Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

    Craig P. Eberson

  3. Department of Orthopaedic Surgery, Division of Spine Surgery, Rhode Island Hospital, Providence, Rhode Island, USA

    Alan H. Daniels

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Treager, C., Isales, C. (2017). Osteomalacia and Rickets. In: Eltorai, A., Eberson, C., Daniels, A. (eds) Orthopedic Surgery Clerkship. Springer, Cham. https://doi.org/10.1007/978-3-319-52567-9_153

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  • DOI: https://doi.org/10.1007/978-3-319-52567-9_153

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52565-5

  • Online ISBN: 978-3-319-52567-9

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