title: [Osteomalacia and vitamin D deficiency].
abstract: BACKGROUND
  Vitamin D and calcium deficiency has a higher incidence in the orthopedic-trauma surgery patient population than generally supposed. In the long term this can result in osteomalacia, a form of altered bone mineralization in adults, in which the cartilaginous, non-calcified osteoid does not mature to hard bone.
  
  
  OBJECTIVE
  The current value of vitamin D and its importance for bones and other body cells are demonstrated.
  
  
  RESULTS
  The causes of vitamin D deficiency are insufficient sunlight exposure, a lack of vitamin D3 and calcium, malabsorption, and rare alterations of VDR signaling and phosphate metabolism. The main symptoms are bone pain, fatigue fractures, muscular cramps, muscle pain, and gait disorders, with an increased incidence of falls in the elderly. Osteopathies induced by pharmaceuticals, tumors, rheumatism or osteoporosis have to be considered as the main differential diagnoses.
  
  
  CONCLUSIONS
  In addition to the recording of symptoms and medical imaging, the diagnosis of osteomalacia should be ensured by laboratory parameters. Adequate treatment consists of the high-dose intake of vitamin D3 and the replacement of phosphate if deficient. Vitamin D is one of the important hormone-like vitamins and is required in all human cells. Deficiency of vitamin D has far-reaching consequences not only for bone, but also for other organ systems.
authors.affiliation: Abteilung für Gelenk- und Extremitätenchirurgie, Franziskushospital Aachen, Praxisklinik Orthopädie Aachen, Sanatoriumstr. 10, 52064, Aachen, Deutschland. rader@praxisklinikorthopaedie.de.
authors.forename: C P
authors.initials: CP
authors.lastname: Rader
authors.affiliation: Abteilung für Gelenk- und Extremitätenchirurgie, Franziskushospital Aachen, Praxisklinik Orthopädie Aachen, Sanatoriumstr. 10, 52064, Aachen, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Corsten
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Franziskus-Hospital Harderberg, Alte Rothenfelder Straße 23, 49124, Georgsmarienhütte, Deutschland.
authors.forename: O
authors.initials: O
authors.lastname: Rolf
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D019587:Dietary Supplements; D019317:Evidence-Based Medicine; D006801:Humans; D010018:Osteomalacia / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D014808:Vitamin D Deficiency / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D050071:Bone Density Conservation Agents; D002762:Cholecalciferol
keywords: Calcium metabolism disorders; Hypophosphatemia; Muscle pain; Osteoporosis; Pathologic decalcification