Looser's Zone.

Osteomalacia is usually neglected when compared with other metabolic bone diseases and may present with a variety of clinical and radiographic manifestations mimicking other musculoskeletal disorders. It is a known cause of persistent, nonspecific musculoskeletal pain. A 35 year old female was admitted with generalized aches and pains for the last two years. She was of thin stature with a BMI of 18 kg/m2, indicative of malnourishment. On examination, vital signs were normal. She had generalized bony tenderness, proximal muscle weakness of both lower limbs. Neurological examination was also normal. Electrolytes were normal. Serum chemistry showed calcium was 8.81 mg/dl, normal ALP and albumin. The rest of the investigations were within normal limits. Chest X ray showed normal parenchyma with looser’s zones. (Fig. 1, 2)