Transcript
Osteomalacia
“Delayed Mineralization”
Metabolic disease characterized by inadequate and
delayed mineralization of osteoid in mature
compact and spongy bone.
Osteomalacia
Osteoblasts brings out new bone by their synthesis of osteoid.
Osteoid bone are non-mineralized bone matrix.
Osteoid
Bone Remodeling Cycle Phase 1 (activation)
a stimulus activates the bone cells precursors in the localized area of the bone to form osteoclasts.
Phase 2. (resorption)
osteoclast forms a “cutting cone” which gradually resorb bone, leaving behind and elongated cavity.
Phase 3 (formation)
laying down of new bone by osteoblast lining the walls of the resorptive cavity.
Bone Remodeling Cycle
Bone Formation
Phase 3 Mineralization
Initiation (Formation) Proliferation (Accretion)
Phase 1 Production of organic
matrixPhase 2 Calcification
Also known as
RICKETS
in infant or growing children
Risks Factor
Risk Factor
Inadequate exposure to sunlight
Risk Factor
Parathyroid gland dysfunction
Risk Factor
Risk Factor •Drugs such as
phenytoin, phenobarbital– Interfere with
calcium absorption and increase in degradation of vitamin D metabolism in the liver.
•Drugs such as phenytoin, phenobarbital– Interfere with
calcium absorption and increase in degradation of vitamin D metabolism in the liver.
Osteomalacia Patho
↑ PTH secretion
INTESTINES ↑ calcium absorption
KIDNEYS ↑ phosphate excretion
(phosphaturia)
Imbalance calcium and phosphate
concentration
Decrease bone crystallization
Osteomalacia
Decrease Calcium
Risks factor
Vitamin D deficiency
Osteomalacia
Knock knees
Bowed legs
asymptomatic until a fracture occurs
Progressive deformities of bones of extremities
and spine
Fractures
Enlarged wrists and ankles
-Kyphoscoliosis
Persistent skeletal pain
Progressive muscle weakness
Rachitic rosary Pigeon chest
Delayed closing of fontanels
Softening skull
- Fractures of bones - Persistent skeletal pain - Progressive deformities of bones of extremities and spine - Progressive muscle weakness - May be asymptomatic until a fracture occurs - Leg and lower back pain due to vertebral collapse - Bowed legs- Knock knees - Rachitic rosary (beading of ends of ribs)
-Enlarged wrists and ankles - Pigeon chest (protruding ribs and sternum) - Delayed closing of fontanels - Softening skull - Bulging forehead - Difficulty walking and climbing stairs -Kyphoscoliosis
Manifestation
Bone Fracture
GENU VALGUM or KNOCK KNEES
RACHITIC ROSARY
PECTUS CARINATUM or PIGEON CHEST
KYPHOSCOLIOSIS
1. Acute Pain r/t stimulation of free nerve endings 2 to muscular stretching or impingement of nerves. 2. Impaired Physical Mobility r/t bone decalcification and bone deformities. 3. High Risk for Injury r/t softening of bones 2 to delayed mineralization 4. Disturbed body image r/t bowing of legs.
Nursing Diagnosis
Laboratory
-Serum calcium concentration less than 7.5 mg/dl - Serum inorganic phosphorus concentration less than 2 mg/dl - Serum citrate level less than 2.5mg/dl - Alkaline phosphatase level less than 4 King Armstrong units/dL
-PTH : < 10 picograms/ml NV 10-55 picograms per milliliter (pg/mL).
Diagnostic studies
IMAGING
X-rays showing characteristics bone deformities and abnormalities such as Looser’s transformation zones (radiolucent bands perpendicular to the surface of the bones indicating reduced bone ossification confirm the diagnosis)
Diagnostic studies
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