Imaging of Musculoskeletal Disorders
Other metabolic bone disease

Osteoporosis is the most common metabolic disease of bone - see previous page.

Other metabolic diseases affecting the bones and joint include osteomalacia, Paget’s disease, and neuropathic arthropathy (also known as Charcot’s disease).

Osteomalacia

The hallmark sign of osteomalacia is the development of pseudofractures, most commonly seen at the medial edge of the femoral neck. These are lucent lines passing part of the way into the bone, but without crossing the whole bone, and surrounding sclerosis.

Pseudofractures are also known as ‘Looser’s zones’.

Paget’s disease

The cardinal features of Paget’s disease are bone expansion and coarsening of the trabecular pattern. Bones affected may become deformed and they have a higher risk of fracturing and of developing osteosarcoma.

Paget’s is usually seen in its chronic form with involvement of the entire bone it affects. It is most often found incidentally as an asymptomatic finding on an X-ray, but it may be painful in its active stage or if it involves a joint surface.

Neuropathic arthropathy/Charcot disease

Peripheral neuropathy causes loss of sensation which can lead to severe secondary degenerative changes in joints.

This neuropathic arthropathy, or Charcot’s disease, is commonly seen in the feet of patients with chronic diabetes. Continued weight-bearing on the insensate foot joints can lead to dislocation and collapse of the arch of the foot.