“ Due to a failure of bone mineralisation (osteomalacia means bone softening). The most common causes are dietary vitamin D deficiency and r...
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Due to a failure of bone mineralisation (osteomalacia means bone softening). The most common causes are dietary vitamin D deficiency and renal osteodystrophy, less commonly gastrointestinal/chronic liver disease, phosphate deficiency, biliary disease, etc.
PLAIN FILM
• Diffusely reduced bone density suggests osteopenia.
• ‘Cortical tunnelling’ are foci of cortical lucency due to accumulation of osteoid in the cortex.
• Coarsened, fuzzy and fewer trabeculae.
• Deformities—bowing, protrusion, basilar invagination.
• Bilateral vertebral endplate collapse giving a ‘fish’ appearance to the disc space.
• ‘Looser zones’ are small lucent lines with sclerotic margins—they represent insufficiency fractures healing with un-mineralised osteoid.
– Bilateral, symmetrical and do not extend across the whole bone.
• Typical sites for looser zones: medial femora, pubic rami, ribs, lateral borders of the scapulae, distal third of the radius, proximal third of the ulna, lesser trochanter and clavicle.
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