The diagnosis of juvenile osteomalacia as an entity apart from juvenile rickets has its proponents and opponents. Hess1 personally felt that the difference in the pathologic lesions is quantitative rather than qualitative and that the underlying pathologic process is the same although there is as yet no satisfactory explanation for the softening of bone which forms so characteristic a phenomenon in osteomalacia.
Locke2 classified the various forms of osteomalacia with regard to age and etiology as follows:
The puerperal form occurs particularly in women who have had numerous and frequent pregnancies. The maternal pelvis, spine and femurs are particularly attacked by the disease. In this form the calcium content of the blood is low and tetany is common. Because of the association of this type with pregnancy, ovarian dysfunction has in the past been thought to be the cause of the disorder and oophorectomy has been