Imaging of metabolic bone diseases

Best Pract Res Clin Rheumatol. 2008 Dec;22(6):1127-39. doi: 10.1016/j.berh.2008.09.016.


Bone scintigraphy and X-ray are complementary in the assessment of Paget's disease. Whereas bone scintigraphy allows visualization of the whole skeleton and 'hot spots', X-ray enables visualization of more detailed images of the pagetic bone lesion. X-ray may be invaluable in the diagnosis of osteomalacia, especially in children. As osteomalacia is characterized by impaired bone mineralization, the use of bone density measures may lead to misinterpretation of the condition as osteoporosis. Dual-energy X-ray absorptiometry at the femoral neck is the 'gold standard' for the assessment of osteoporosis. However, all devices are useful to predict the risk of fracture. In the future, high-resolution computer tomography and magnetic resonance imaging may become valuable clinical tools, capturing the architectural aspect of bone strength and improving fracture prediction models.

Publication types

  • Review

MeSH terms

  • Absorptiometry, Photon
  • Bone Density
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / pathology
  • Diagnostic Imaging / methods*
  • Humans
  • Osteitis Deformans / diagnostic imaging*
  • Osteomalacia / diagnostic imaging*
  • Osteoporosis / diagnostic imaging*
  • Radionuclide Imaging