Bone densitometry showed osteoporosis with a lumbar spine (L1–L4) T score of −3.1 and a femur (neck) T score of −2.8. Bone scintigraphy revealed multiple osteogenic reaction areas, with predominance in the axial skeleton ( Figure 1). Radiography showed fractures of nine costal arches and of the left clavicle. The patient was using levothyroxine, omeprazole, metformin, glymepiride, milnacipran, mirtazapine and atenolol. Comorbidities included hypertension, diabetes mellitus, hypothyroidism, depression and neurological sequelae with left hemiparesis. She had suffered from multiple fractures of the ribs and the left clavicle without trauma for two months before she was admitted to the hospital. We report the case of a 62-year-old woman who had experienced body pains and weakness for two years. 5, 9 The elderly are at particularly high risk for developing osteomalacia, which is frequently misdiagnosed. 2 Vitamin D deficiency is a pathogenic factor of osteoporosis that can be modified. 1 It is typically caused by lack of vitamin D and is characterized by mineralization deficiency of the osteoid matrix in the cortical and trabecular bone, resulting in accumulation of osteoid tissue. Osteomalacia is one of the most common osteometabolic diseases among the elderly and may be associated with osteoporosis.
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