[Osteomalacia caused by hypovitaminosis with moderate secondary hyperparathyroidism (so-called intestinal osteopathy) on the basis of endemic sprue in a condition of post-celiac disease 1948 and insufficient ultraviolet exposure].

Painful sacro-iliac joints and hips in a 37 year old male patient caused difficulties in differential diagnosis because of scintigraphic positive scans over the sacro-iliac joints: intestinal hypovitaminotic osteomalacia or ankylosing spondylitis? Laboratory findings with low serum calcium, low urine calcium, high alkaline phosphatase and low 25-Hydroxy-vitamin D levels together with high levels of parathormone led to the final diagnosis of osteomalacia. Typical x-ray changes were also present. Prompt relief of clinical symptoms was achieved by high dose vitamin-D therapy.