[The present status and possible causes of error in the diagnosis of osteomalacia]

The author compares the diagnostic standard of osteomalacia in a group of 135 patients during the past seven years with a similar group of patients published previously. The number of correct diagnoses increased from 10% to 14.07%, while the number of diagnoses assessed when searching for decalcification of bones and those assessed incidentally by laboratory methods and X-ray remained relatively stable. The number of incorrect diagnoses declined from 8.95% to 6.66% and the period before the final correction of the diagnosis declined from 1.72 years to 1.02 years. As regards the causes of osteomalacia, the diagnosis in renal diseases improved markedly, while it did not improve in malabsorptions and liver diseases. To improve this state of affairs the author recommends in the first place to consider the possible presence of osteomalacia, to use for orientation the classical and irreplaceable laboratory and X-ray finding. In case of doubt, it is always possible to use the therapeutic test with vitamin D or its metabolites.