A 25-year-old male visits the office complaining of recent bilateral hip pain. He had trouble walking as a result of the discomfort, which crept up on him slowly at first. The patient has never experienced trauma. His medical history is important because he has taken phenytoin for the past five years to treat a seizure disorder. The patient stays away from alcohol and tobacco use. An X-ray of the hip joint reveals diffuse cortical thinning and bilateral, symmetric, narrow radiolucent lines that are 2-3 mm wide with sclerotic borders as well as diffuse cortical thinning. Which of the following is the most likely cause of this patient's current condition?

Question

A 25-year-old male visits the office complaining of recent bilateral hip pain. He had trouble walking as a result of the discomfort, which crept up on him slowly at first. The patient has never experienced trauma. His medical history is important because he has taken phenytoin for the past five years to treat a seizure disorder. The patient stays away from alcohol and tobacco use. An X-ray of the hip joint reveals diffuse cortical thinning and bilateral, symmetric, narrow radiolucent lines that are 2-3 mm wide with sclerotic borders as well as diffuse cortical thinning.  Which of the following is the most likely cause of this patient's current condition?

Quizplus · Accepted Answer

Eductional Objective: Osteomalacia is most commonly due to vitamin D deficiency, which reduces intestinal calcium absorption, leading to secondary hyperparathyroidism and renal phosphate wasting. Patients taking long-term anticonvulsant therapy (eg, carbamazepine, phenytoin) require vitamin D supplementation.

A 25-Year-Old Male Visits the Office Complaining of Recent Bilateral