The clinical features of rickets or osteomalacia are characterised by bone pain, occasional fracture, and sometimes deformity, particularly in patients with long-standing osteomalacia due to hereditary conditions or chronic renal disease (Fig. 18.22). This occurs particularly in children with renal rickets or sex-linked hypophosphataemic rickets who may have outward bowing of the lower extremities. Patients with osteomalacia also develop muscle weakness and tenderness, particularly affecting the proximal muscles of the lower extremities.
