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December 1956

Severe Osteomalacia Associated with Occult Steatorrhea Due to Nontropical Sprue: Report of Five Cases

Author Affiliations

Rochester, Minn.

AMA Arch Intern Med. 1956;98(6):774-782. doi:10.1001/archinte.1956.00250300092011

Osteomalacia is a metabolic disturbance of bone characterized by insufficient deposition of calcium salts into bone matrix. Patients with this disease often complain of muscular weakness and skeletal pain. They may exhibit deformities of bones, and not infrequently they have hypocalcemic tetany. The concentrations of either the serum calcium or the serum inorganic phosphorus or both are found to be low; the level of serum alkaline phosphatase is frequently elevated.1 As the disease progresses, roentgenograms may reveal diminished density of bones, particularly of the long bones of the extremities and the vertebrae. Linear zones of decreased density, first described by Looser 2 and later termed "pseudofractures" by Milkman,3 may become evident. These seams of decalcified osteoid tissue tend to be symmetrically located and are most commonly found at the axillary edge of the scapulae and in the neck of the femurs, the pubic and ischial rami, and the

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