Osteoporosis radiographic manifestations:
1. The vertebral bodies may develop a biconcave shape or compression fractures.
2. In tubular bones the trabecular bone loss may cause the metaphyses to appear radiolucent.
3. Pathological fractures may occur at multiple sites.
4. Schmorls nodes.
5. Acute and insufficiency fractures.
6. MR imaging:
(A) In transient osteoporosis of the hip manifested as decreased signal intensity on T1-weighted sequences and increased signal intensity on T2-weighted sequences.
(B) The patient commonly has associated joint effusions in the affected hip.
(C) Chemical shift fat suppression and STIR imaging techniques can be effective in the detection of transient bone marrow oedema.
Osteomalacia radiographic manifestations:
1. Loosers zones (cortical fractures on the compression side of the bone) or Milkmans pseudofractures are strongly suggestive but not diagnostic of osteomalacia. i.e. linear lucencies oriented perpendicular to the cortical margin.
2. Decreased bone density (Osteopenia).
3. Coarsening of the trabecular pattern and cortical striations.
4. Cortical thinning.
5. MRI : insufficiency fractures seen as a hypointense lines or fissures on T1- and T2-weighted and STIR MR images.
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