Summary
- Impaired bone metabolism causing weakness and insufficiency fractures, including achilles avulsion fractures.
Diagnostic tips
- Vitamin D, phosphate, calcium deficiency
- Dull bone pain
- Exclude coeliac disease, liver disease, renal failure.
Tests and Imaging
- Blood tests for calcium, phosphorus, Vitamin D, Alkaline phosphatase, and parathyroid hormone.
- Xray may small insufficiency fractures
Immediate Treatment
- Vitamin D Supplements
- Dietary advice
- Stabilise fractures
Possible Referral
- Podiatry for management of foot pain, splinting/immobilisation, footwear advice and exercises.
