OSTEOMALACIA IN RHEUMATOID ARTHRITIS

Osteomalacia and biochemical evidence of vitamin-D deficiency may in some
cases contribute to the pathogenesis of osteopenia and increase the risk of spontaneous fracture
formation in rheumatoid arthritis (RA).
Materials & Methods: A consecutive series of 93 patients diagnosed with RA who were admitted to
the Internal Medicine Department

of Ghem Medical Center in Mashhad were screened for clinical,
laboratory and radiologic evidences of osteomalacia.
Results: We found three patients whose clinical and paraclinical features (especially Looser’s Zone in
plain radiography) complied with osteomalacia. All affected patients were elderly women who had a
poor diet

and were virtually housebound. Biochemical

screening was of limited value in differential
diagnosis, since

elevated serum alkaline phosphatase levels were noted in both

osteomalacia and nonosteomalacia
patients.

Conclusion: This study indicates that although diagnosis and consequent treatment of osteomalacia
may considerably prevent morbidity and mortality in RA, screening for osteomalacia should be limited
to elderly women with risk factors such as poor diet and sedentary lifestyle.