Systematic approach to metabolic diseases of bone

Abstract

This chapter begins with a brief introduction to bone metabolism. The main focus is discussing generalized diminished bone density (GDBD), but examples of generalized increased bone density are also briefly presented. Since various causes of GDBD are not considered in the WHO definitions, a radiologic classification based on pathophysiology of GDBD will follow, complementing the WHO definitions and distinguishing osteoporosis from osteomalacia, osteolysis, and marrow proliferative disorders. The primary and secondary osteoporoses are discussed. Diagnostic imaging of osteoporosis by radiography, dual X-ray absorptiometry (DXA), quantitative CT analysis, microcomputerized tomography, quantitative ultrasonography, and MRI is briefly reported. The major risk of advanced osteoporosis is fracture of the spine, hip, and less frequently other bones. A summarized treatment of osteoporosis is followed by discussion of osteomalacia, rickets, hypervitaminoses D and A, as well as fluorosis. © 2010 Humana Press.