3 osteomalacia

CLINICAL IMAGAGING�AN ATLAS OF DIFFERENTIAL DAIGNOSIS�EISENBERG

1. 3 Osteomalacia

2. CLINICAL IMAGAGING AN ATLAS OF DIFFERENTIAL DAIGNOSIS EISENBERG DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

3. Fig B 3-1 Rickets. (A) Initial film shows severe metaphyseal changes involving the distal femurs and proximal tibias and fibulas. Note the pronounced demineralization of the epiphyseal ossification centers. (B) After vitamin D therapy, there is remineralization of the metaphyses and an almost normal appearance of the epiphyseal ossification centers.

4. Fig B 3-2 Rickets due to renal tubular disorder. Striking thickening of the cortices of the vertebral bodies with increased trabeculation of spongy bone.

5. Fig B 3-3 Hyperparathyroidism. Views of (A) the chest and (B) the abdomen show generalized bony demineralization with striking prominence of residual trabeculae (especially in the ribs).

6. Fig B 3-4 Hypophosphatasia. Osteomalacia of the arm with ossification of the deltoid and other muscle insertions. Severe manifestations of the condition in a 43-year-old man, 4 feet 9 inches tall. 5

7. Fig B 3-5 Wilson's disease. Lateral view of the ankle and foot demonstrates marked demineralization, thinning of the cortex, and coarsening of the trabecular pattern, all best seen in the os calcis. 6