Osteomalacia in the elderly: investigation and diagnosis

Osteomalacia in New Zealand and Australia has previously been thought rare. The medical records of 22 elderly inpatients diagnosed as having osteomalacia on biopsy criteria in Dunedin between January 1980 and December 1983 were reviewed. Risk factors, mode of presentation, month of presentation, biochemistry, bone biopsy, bright line counting and bone scans were assessed. Our findings, and a review of the diagnosis of osteomalacia in the elderly are discussed. We conclude that in the elderly, osteomalacia is not uncommon, and recommend increased attention to risk factors and biochemical screening.