What radiographic features characterize osteomalacia in adults?

• A. Looser zones/pseudofractures and diffuse osteopenia.
• B. Metaphyseal cupping.
• C. Epiphyseal overgrowth.
• D. Osteophyte formation.

Answer: (A)

Osteomalacia in adults arises from defective mineralization of the osteoid, most commonly due to vitamin D deficiency. On radiographs the key features are diffuse osteopenia, reflecting reduced bone density, and Looser zones (pseudofractures): transverse lucent lines that run perpendicular to the cortex in weight‑bearing bones such as the ribs, pelvis, femoral neck, and scapula. These lines represent incomplete fractures in inadequately mineralized bone, often with sclerotic margins from repaired bone. Because growth plates are already closed in adults, metaphyseal cupping or fraying seen in rickets is not present. Osteophyte formation is related to degenerative changes, not osteomalacia.