Metabolic and endocrine disorders can significantly impact the musculoskeletal system, affecting bone, muscle, tendons, ligaments, and soft tissues. Disruptions caused by hormonal imbalances, genetic predispositions, or environmental and nutritional factors manifest in diverse clinical and imaging signs. Radiologists play a crucial role in both detecting established complications and identifying subtle imaging biomarkers indicative of underlying disorders. Early diagnosis is vital to prevent serious consequences like fractures and chronic pain, which impact quality of life. This chapter explores the systemic effects of metabolic and endocrine disorders, focusing on their imaging characteristics and their complications.