Metabolic and Endocrine Disorders

Metabolic diseases of the skeleton affect bone as a tissue, causing alterations in mass, mineralization, turnover, and bone growth. They may be caused by genetic, endocrine, nutritional, or biochemical disorders. Every bone is involved histologically, but radiological features are not always evident. The knowledge of their pathophysiology is essential to the understanding of the effects that metabolic bone disorders have on the skeleton and in interpreting the abnormal features which they cause on radiographs and other imaging techniques. Osteoporosis is the most common metabolic disease, characterized by low bone mass and microarchitecture degeneration with impaired bone quality, resulting in increased skeletal frailty and thus increased risk of fractures. Other metabolic conditions affect bone in diverse ways and have distinctive features. In this chapter, we will review the manifestations of metabolic bone disease around the hip and the essentials for diagnosis, focusing on the possibilities of imaging diagnosis, from the basic to the most advanced.