Making the Diagnosis
A doctor who suspects osteomalacia will want to know about the person's medical history and lifestyle. This information is required to determine the amount of vitamin D the person receives from their diet and from the sun. The following tests may help make the diagnosis:
- blood tests to measure levels of calcium and phosphate
- X-rays - images of the leg bones to look for abnormalities such as pseudofractures (lines that look like fractures on the X-ray but aren't actual fractures); X-rays of other bones, such as the pelvis, may also show changes in shape
- CT (computed tomography) scans of the spine to show changes in the vertebrae
- a bone biopsy - a needle is inserted into the bone to allow the doctor to remove a small piece of bone tissue for analysis
Once osteomalacia or rickets has been diagnosed, the doctor must find out why the condition has developed. Although osteomalacia may be caused by a lack of vitamin D in the diet, the cause may be more complex, relating not to dietary deficiency of the vitamin but rather a failure to absorb or activate the vitamin. In such cases, further investigations to search for kidney or intestinal problems are needed.