The spectrum of pathology in osteomalacia

A classification and discussion of the histology of osteomalacia and the current histological techniques used in its identification are presented. Three categories of histologic features of osteomalacic bone are proposed: (1) increased osteoid, elevated osteoblast and osteoclast numbers and marrow fibrosis; (2) increased osteoid and osteoblast numbers, and (3) increased osteoid associated with few osteoblasts. Clinical conditions for which quantitative bone histomorphometric data are available are presented and related to the three categories. The consistency of clinical pathophysiology and histologic bone features is emphasized.