A 46-year-old woman presents with pain in the left leg that worsens on weight bearing. An x-ray shows demineralization, and a bone biopsy decalcified with EDTA shows reduction in bone quantity. The patient had undergone menopause at age 45 without estrogen replacement. She reports long-standing diarrhea. In addition, laboratory tests show low levels of vitamin D, calcium, and phosphorus, and elevated alkaline phosphatase. A second bone biopsy was taken but not decalcified, which showed extensive deposition of uncalcified osteoid on all the bone surfaces. On the basis of these data, the best diagnosis would be which of the following?

Question

Quizplus · Accepted Answer

The patient's symptoms and lab findings, including low vitamin D, calcium, and phosphorus levels, along with elevated alkaline phosphatase and uncalcified osteoid deposition, are indicative of osteomalacia, a condition characterized by defective bone mineralization due to vitamin D deficiency.

A 46-Year-Old Woman Presents with Pain in the Left Leg