{"title":"脆性骨成像:成人的诊断程序。","authors":"Catherine Cyteval, Paulina Szafors, Maxime Pastor","doi":"10.1055/s-0043-1769776","DOIUrl":null,"url":null,"abstract":"<p><p>This article concentrates on generalized disorders causing bone fragility. The most frequent cause of brittle bone disease is osteoporosis, only diagnosed by elimination. First, malignant osteopathy must be ruled out: fracture on metastasis or multiple myeloma, which mimics osteoporosis when presenting as diffuse demineralization. Second, patients should be screened for signs of hyperparathyroidism or osteomalacia. Much more rarely, many other pathologies can lead to brittle bone by demineralization or associated increased bone density.The radiologist needs to know the clinical context and notably the patient's age (childhood or adulthood) at discovery, and known pathologies and ongoing or previous treatments: corticotherapy, bisphosphonates, denosumab, or prior radiotherapy in the affected region. Diagnostic hypotheses are guided by the type of demineralization and the presence of lytic, mixed, or densifying areas. Lastly, the aspect and location of fractures and association with other bone abnormalities refine the diagnosis.</p>","PeriodicalId":49545,"journal":{"name":"Seminars in Musculoskeletal Radiology","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Brittle Bone Imaging: Diagnostic Procedures in Adults.\",\"authors\":\"Catherine Cyteval, Paulina Szafors, Maxime Pastor\",\"doi\":\"10.1055/s-0043-1769776\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This article concentrates on generalized disorders causing bone fragility. The most frequent cause of brittle bone disease is osteoporosis, only diagnosed by elimination. First, malignant osteopathy must be ruled out: fracture on metastasis or multiple myeloma, which mimics osteoporosis when presenting as diffuse demineralization. Second, patients should be screened for signs of hyperparathyroidism or osteomalacia. Much more rarely, many other pathologies can lead to brittle bone by demineralization or associated increased bone density.The radiologist needs to know the clinical context and notably the patient's age (childhood or adulthood) at discovery, and known pathologies and ongoing or previous treatments: corticotherapy, bisphosphonates, denosumab, or prior radiotherapy in the affected region. Diagnostic hypotheses are guided by the type of demineralization and the presence of lytic, mixed, or densifying areas. Lastly, the aspect and location of fractures and association with other bone abnormalities refine the diagnosis.</p>\",\"PeriodicalId\":49545,\"journal\":{\"name\":\"Seminars in Musculoskeletal Radiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seminars in Musculoskeletal Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0043-1769776\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/9/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Musculoskeletal Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/s-0043-1769776","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/25 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Brittle Bone Imaging: Diagnostic Procedures in Adults.
This article concentrates on generalized disorders causing bone fragility. The most frequent cause of brittle bone disease is osteoporosis, only diagnosed by elimination. First, malignant osteopathy must be ruled out: fracture on metastasis or multiple myeloma, which mimics osteoporosis when presenting as diffuse demineralization. Second, patients should be screened for signs of hyperparathyroidism or osteomalacia. Much more rarely, many other pathologies can lead to brittle bone by demineralization or associated increased bone density.The radiologist needs to know the clinical context and notably the patient's age (childhood or adulthood) at discovery, and known pathologies and ongoing or previous treatments: corticotherapy, bisphosphonates, denosumab, or prior radiotherapy in the affected region. Diagnostic hypotheses are guided by the type of demineralization and the presence of lytic, mixed, or densifying areas. Lastly, the aspect and location of fractures and association with other bone abnormalities refine the diagnosis.
期刊介绍:
Seminars in Musculoskeletal Radiology is a review journal that is devoted to musculoskeletal and associated imaging techniques. The journal''s topical issues encompass a broad spectrum of radiological imaging including body MRI imaging, cross sectional radiology, ultrasound and biomechanics. The journal also covers advanced imaging techniques of metabolic bone disease and other areas like the foot and ankle, wrist, spine and other extremities.
The journal''s content is suitable for both the practicing radiologist as well as residents in training.