Presentation
Pelvic pain.
Patient Data
Age: 24-year-old
Gender: Female
From the case:
Osteomalacia
Frontal
- Triradiate appearance of the pelvis with bilateral acetabula protrusio.
- Osteopenic texture of the examined bones with coarse trabeculae.
- Right superior and inferior pubic rami Looser's zones.
- Subchondral bone absorption of acroiliac joints (more on the right).
From the case:
Osteomalacia
Loading images...
Coronal T1
MRI exam of the pelvis showed:
- Triradiate appearance of the pelvis with bilateral acetabula protrusio.
- Right superior and inferior pubic rami looser's zones. Also note the marrow edema of the left femoral neck, likely stress fracture.
- Subchondral bone absorption of acroiliac joints (more on the right).
From the case:
Osteomalacia
Loading images...
AP
Red arrows: represent stress fractures (looser's zones)
Yellow arrows: represent subchondral bony resorption at the sacroiliac joint.
Case Discussion
The patient had a history of chronic renal disease.
Osteomalacia is bone softening due to insufficient mineralization of the osteoid secondary to any process that results in vitamin D deficiency or defects in phosphate metabolism.
Radiographic features
Musculoskeletal
There can be variable appearances dependant on the cause :
- diffuse demineralization: osteoporotic-like pattern
- coarsened trabeculae
- insufficiency fractures
- pseudofractures (Looser zones)
- articular manifestations (uncommon)
- protrusio acetabuli
- rheumatoid arthritis-like changes
- osteogenic synovitis
- ankylosing spondylitis-like changes
Unable to process the form. Check for errors and try again.