Metabolic bone disease in X-ray

Osteoporosis

"ส่วนประกอบปกติ Mineralization ปกติ"

• Finding : 
• Decrease number & thickness of trabeculae
• Cortical thinning
• Spine : Wedge compression fracture, Fish vertebra
• Femur : Line of stress, Bone bar

Rickets

"ภาวะขาด Mineralization ในเด็ก"

• Finding :
• Widening growth plate
• Fraying of metaphysis border
• Ill-defined cortical border at Epiphysis
• Frontal bossing  (Delay closing of frontanelle)
• Rachitic rosary  (Costochondral junction enlargement)

Osteomalacia

"Vitamin D absorption failure"

• Finding :
• Looser's zone : Lucent band across cortex  *** เป็น Hallmark
• Fuzzy indistinct trabecular detail
• Fish vertebra
• Protrusio acetabuli
• Platybasia  : Flattening of skull base

Hyperparathyroidism

• Finding :
• Superiosteal bone resorption => Intracortical => Endosteal => Trabecular bone resorption
• Subchondral / Subphysial bone resorption
• Salt and pepper appearance = Trabecular bone resorption at Skull
• Brown tumor = Single/Multiple well-defined eccentric/cortical osteolytic lesion
• Sign :
• Brown tumor, Chondrocalcinosis ==>M/C is Primary
• Osteosclerosis, Periostitis  ==> M/C is Secondary