Diagnosis

Osteomalacia can be difficult to diagnose. To pinpoint the cause and to rule out other bone disorders, such as osteoporosis, you might undergo one or more of the following tests:

  • Blood and urine tests. These help detect low levels of vitamin D and problems with calcium and phosphorus.
  • X-rays. Slight cracks in your bones that are visible on X-rays are characteristic of osteomalacia.
  • Bone biopsy. Using general anesthesia, a surgeon inserts a slender needle through your skin and into your pelvic bone above the hip to withdraw a small sample of bone. Although a bone biopsy is accurate in detecting osteomalacia, it's rarely needed to make the diagnosis.

Treatment

Fortunately, getting enough vitamin D through oral supplements for several weeks to months can cure osteomalacia. Maintaining normal blood levels of vitamin D usually requires continuing to take the supplements.

Your health care provider might also recommend that you increase your calcium or phosphorus intake, either through supplements or diet. Treating conditions that affect vitamin D metabolism, such as kidney and liver disease or low phosphate levels, often helps improve the signs and symptoms of osteomalacia.

Preparing for your appointment

You'll likely start by seeing your primary care provider, who might refer you to a doctor who specializes in diseases of the joints and muscles (rheumatologist) or one who specializes in metabolic bone disorders (endocrinologist).

Make a list of:

  • Your symptoms, including any that seem unrelated to your reason for making the appointment and when they began
  • Key personal information, including other medical conditions and family medical history
  • All medications, vitamins and other supplements, including doses
  • Questions to ask your doctor

For osteomalacia, basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • What tests do I need?
  • What treatment do you recommend?
  • Do I need to change my diet or lifestyle?
  • Am I at risk of long-term complications from this condition?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, including:

  • Where do you feel pain?
  • When did your pain start, and has it progressed?
  • Are any areas tender to the touch?
  • Is your pain constant or does it come and go?
  • Does anything make your symptoms better or worse?
  • Have you had gastric bypass surgery or other bowel surgery?
  • What treatments have you tried so far, if any? Has anything helped?
April 29, 2017
References
  1. Drezner MK. Clinical manifestations, diagnosis, and treatment of osteomalacia. http://www.uptodate.com/home. Accessed Dec. 18, 2016.
  2. Osteomalacia. Genetic and Rare Diseases Information Center. https://rarediseases.info.nih.gov/diseases/7285/osteomalacia. Accessed Dec. 18, 2016.
  3. Chen J, et al. Vitamin D deficiency and sub-clinical osteomalacia in axial spondyloarthropathy. Rheumatology. 2016;6:1.
  4. Bhan A, et al. Osteomalacia as a result of vitamin D deficiency. Rheumatology Disease Clinics of North America. 2012;38:81.
  5. Menkes CJ. Epidemiology and etiology of osteomalacia. http://www.uptodate.com/home. Accessed Dec. 18, 2016.
  6. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. Chevy Chase, Md.: The Endocrine Society. http://www.endocrine.org/education-and-practice-management/clinical-practice-guidelines. Accessed Dec. 19, 2016.
  7. Vitamin D. American Academy of Dermatology. https://www.aad.org/media/stats/prevention-and-care/vitamin-d-and-uv-exposure. Accessed Dec. 19, 2016.