Background & Aims : 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 Lo o ser’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 non-osteomalacia 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.

 SOURCE: URMIA MED J 2015: 25(11): 1010 ISSN: 1027-3727