Clinical features

The essential features of osteomalacia are those of osteopenia - bone pain, skeletal deformity and fractures.

However, in osteomalacia:

• the disease tends to run an insidious and vague course
• the patient is often ill
• deformities such as a mild kyphosis or knock knees which may have been due to adolescent rickets will often worsen
• unexplained pain in the hip may indicate a stress fracture
• muscle weakness may be marked - usually most noticeable in the quadriceps and glutei, producing a waddling gait and causing difficulty in rising from a chair

There are often signs of underlying disease. Not uncommonly, osteomalacia is discovered incidentally.