Metabolic and Endocrine Disorders
Hand and wrist are well recognized as a mirror of disease for various metabolic and endocrine pathologic conditions. Among them, osteoporosis is the most common metabolic bone disorder. It is defined as “a skeletal disease, characterized by decreased bone
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Contents
Abstract
1
Introduction.............................................................. 215
2
Classification of Osteoporosis................................. 216
3 3.1 3.2 3.3 3.4 3.5
Diagnosis of Osteoporosis ....................................... Conventional Radiography ........................................ Peripheral Dual-Energy X-Ray Absorptiometry ...... Peripheral Quantitative Computed Tomography...... Quantitative Ultrasound............................................. Magnetic Resonance..................................................
216 216 217 218 220 222
4 4.1 4.2 4.3 4.4 4.5 4.6 4.7
Other Metabolic and Endocrine Disorders .......... Acromegaly and Gigantism....................................... Hypopituitarism ......................................................... Thyroid Disorders...................................................... Hyperparathyroidism ................................................. Rickets and Osteomalacia ......................................... Hypoparathyroidism .................................................. Scurvy ........................................................................
223 223 224 224 224 226 226 228
5
Conclusions ............................................................... 228
6
Key Points................................................................. 228
References.......................................................................... 228
G. Guglielmi (&) S. Muscarella Department of Radiology, University of Foggia, Viale L. Pinto 1, 71100 Foggia, Italy e-mail: [email protected] G. Guglielmi S. Muscarella Department of Radiology, Hospital ‘‘Casa Sollievo della Sofferenza’’, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Italy
Hand and wrist are well recognized as a mirror of disease for various metabolic and endocrine pathologic conditions. Among them, osteoporosis is the most common metabolic bone disorder. It is defined as ‘‘a skeletal disease, characterized by decreased bone mineral density (BMD) and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture’’ . As a disease of the elderly, its prevalence will increase as the population ages leading to a need to intensify and optimize the diagnostic techniques for its assessment. BMD is a measurement of bone mass and a reflection of the amount of calcium in bone. Currently, the gold standard for measuring BMD is Dual-energy X-ray Absorptiometry (DXA).
1
Introduction
Hand and wrist are well recognized as a mirror of disease for various metabolic and endocrine pathologic conditions (Theodorou et al. 2001). Among them, osteoporosis is the most common metabolic bone disorder. It is defined as ‘‘a skeletal disease, characterized by decreased bone mineral density (BMD) and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture’’ (Anonymous 2003). As a disease of the elderly, its prevalence will increase as the populatio
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