Osteomalacia, myopathy and basilar impression

Abstract A 55-year-old farmer was described with a 2-year history of progressive weakness in the limbs and bone pains. In the last 10 years since he became blind due to bilateral retinal detachment he was rarely exposed to sunlight. Being a vegetarian his diet was grossly inadequate in Ca and vitamin D. Examination revealed proximal muscular weakness, diffuse bone tenderness, loss of height and a low hair line. Relevant investigations revealed osteomalacia, proximal myopathy and basilar impression of the skull. The literature with respect to the role of vitamin D in the production of osteomalacia and muscular weakness is reviewed.