A 45 year old female presented with pain in the pelvic girdle.X ray shows the following features.What can be the most possible diagnosis?
A. Osteogenesis Imperfecta
Image shows:Looser zones :Symmetric transverse lucent areas in the medial aspect of the femoral necks (arrows): a manifestation of osteomalacia.
- Vitamin D deficiency is the most common cause of osteomalacia
- Painful proximal muscle weakness (especially pelvic girdle); bone pain and tenderness.
- Decreased bone density from defective mineralization.
- Decrease in the rate of bone turnover and an increase in the amount of uncalcified osteoid.
- Increased alkaline phosphatase
- Decreased 25-hydroxyvitamin D
- Secondary hyperparathyroidism
- The classical feature: Pseudo fracture or Looser’s zone
- Triradiate pelvis in females
- Protrusion-acetabuli: acetabulum protruding into the pelvis.
- More commonly there is diffuse fading of skeleton leading to biconcave (cod fish) vertebra due to disc pressure and indentation of acetabulum producing trefoil or champagne glass pelvis.