Hello and welcome to the Zero to Finals podcast.

My name is Tom, and in this episode I'm going to be talking to you about OsteoMalacia.

And if you want to follow along with written notes on this topic, you can follow along at

0.com slash osteomalacia or in the rheumatology section of the zero to finals medicine book.

So let's get straight into it.

Osteoamalacia is a condition where there is defective bone mineralization and this results

in soft bones.

Osteo means bone and Malaysia means soft.

This is a result of insufficient vitamin D and it presents with weak bones, bone pain, muscle weakness and fractures.

When this occurs in children prior to their growth plates closing,

it leads to a condition called rickets.

So first let's talk about the path of physiology.

Vitamin D is a hormone, so most people think it's a vitamin, but technically it's a hormone,

that's created from cholesterol in the skin in response to UV radiation, so ultraviolet light.

Patients with darker skin require longer periods of sun exposure to generate the same

quantity of vitamin D as somebody with lighter skin. A standard diet generally contains inadequate

levels of vitamin D to compensate for a lack of sun exposure.

So if the patient's not getting enough sun exposure, it's unlikely that their diet will contain enough vitamin D.

So reduce sun exposure without vitamin D supplementation leads to vitamin D deficiency.

Patients with malabsorption disorders, for example inflammatory bowel disease,

are more likely to be vitamin D deficient because they're not absorbing as much vitamin D from the diet.

The kidneys are essential in metabolizing vitamin D into its active form.

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