(Endocrine & Metabolic)

Overview

• Softening of the bones secondary to low vitamin D levels that in turn lead to decreased bone mineral content
• Rickets → disorder of impaired mineralisation of cartilaginous growth plates (only occurs in children)

Most common causes:

• Vitamin D Deficiency → reduced exposure to sunlight, low dietary intake, reduced intestinal absorption (coeliac disease, chronic pancreatitis)
• Defective Vitamin D Metabolism → liver cirrhosis, CKD
• Drugs → anticonvulsants

Making Diagnosis

Clinical Features:

• Bone pain & tenderness
• Pathological fractures → occur with mild trauma. Especially femoral neck.
• Proximal Myopathy → muscle weakness, spasms, cramps. May lead to waddling gait.
• Fatigue
• Symtpoms of Hypocalcaemia (due to vit D deficiency) → tetany, muscle twitching, paraesthesia, arrhythmias (CATs go Numb)