Osteomalacia as a Cause of Chronic Pain

• Main Authors: Robert W Teasell, Greg Sue-A-Quan, Bernard M Wolfe
• Format: Article
• Language: English
• Published: Hindawi Limited 1996-01-01
• Series: Pain Research and Management
• Online Access: http://dx.doi.org/10.1155/1996/695740

Osteomalacia is a form of metabolic bone disease that can present as chronic pain. A 36-year-old woman presented with a three-year history of bilateral leg and back pain, and proximal leg weakness. Repeated consultations and investigations failed to discover a cause for her pain, and a diagnosis of chronic benign pain was made. She was admitted to hospital where the bone scan, laboratory investigation and bone biopsy established a diagnosis of renal phosphate-wasting adult-onset rickets (osteomalacia). Radiographs of the hip and magnetic resonance imaging revealed bilateral femoral neck fractures and segmental, avascular necrosis of the femoral heads. The patient was treated with high dose phosphate and vitamin D with marked relief of pain. Osteomalacia should be considered in unusual cases of intractable chronic pain.