Bone or Joint Disorders Related to Metabolic Bone Diseases:

Bone and joint pain and fractures can be prominent manifestations of osteoporosis and osteomalacia (refer to: Metabolic Bone Diseases). Osteoporosis is characterized by a decreased mass of normally mineralized bone. Osteomalacia is caused by an excess of unmineralized bone resulting from an impairment of bone mineralization. The causes of these bone diseases and conditions associated with them are discussed elsewhere (refer to: Metabolic Bone Diseases) and are summarized herewith (Table). <><>

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Causes of Osteoporosis/Osteopenia and Osteomalacia
Osteoporosis/Osteopenia	Osteomalacia
Aging	Reduction of vitamin D metabolites:
Endocrine abnormality:	vitamin D malabsorption
estrogen deficiency	abnormal vitamin D metabolism
glucocorticoid excess	low UV light/ diet lack
primary hyperparathyroidism	loss of kidney parenchyma
Immobilization	Peripheral resistance to vitamin D:
Genetic/heritable disorders of connective tissue	chronic renal failure
Rheumatoid arthritis	dilantin/phenobarbital
Scurvy	Hypophosphatemia:
Heparin therapy	malnutrition
Cancer:	malabsorption
multiple myeloma	chronic dialysis
leukemia/lymphoma	renal phosphate wasting
Liver disease
Alcoholism