Osteomalacia

A s the awareness of their clinical manifestations grows, osteomalacia and rickets, which is its counterpart in the growing child, are recognised more often. Osteomalacia occurs mainly in patients with malabsorption syndrome (Bennett et al., 1932; Salvesen & Boe, 1953; Steinbach et al., 1954; Juergens et al., 1956), or as a complication of gastric surgery (Pyrah & Smith, 1956; Jones et al., 1962; Dellar et al., 1964; Clark et al., 1964; Morgan et al., 1965). In Glasgow, both osteomalacia and rickets have been reported in the Pakistani population (Dunnigan et al., 1962; Dunnigan & Smith, 1965), and Arneil et al. (1965) have produced evidence that there is a rising incidence of rickets in children presenting at the Royal Hospital for Sick Children, Glasgow, over the period 1958 to 1964. On page 429 of this issue of the Scottish Medical Journal, Dr Anderson and his colleagues describe the occurrence of osteomalacia in patients admitted to a busy geriatric unit in Glasgow. It was found in 12 out of 100 patients who were investigated because their symptoms suggested the possible presence of the condition. Moreover, osteomalacia was present in 4 out of 100 patients admitted consecutively to the ward for other reasons. There must therefore be a significant number of persons in the general population with osteomalacia in whom considerable disability has been present for some time. It is important that this should be recognised since osteomalacia can be successfully treated. Osteoid is bone collagen which has been laid down but has failed to calcify and osteomalacia is characterised by the presence of osteoid borders. These borders are, however, found in a number of other clinical conditions. Thus, they may be present in chronic renal failure and in the bones of patients with renal tubular defects, such as renal tubular acidosis, and in the Fanconi syndrome. They may be Scot. moo. .t., 1966, 11 :"448