The presence of 8 metabolic features was assessed on the bone scintigrams of 10 patients with osteomalacia. In all of these bone images, sufficient features were present to strongly suggest a metabolic disorder. These scintiphotos were included in a controlled blind study using 30 normal bone scans and 20 scans of metastatic disease. Nine of the 10 metabolic bone images were correctly identified by 2 independent observers. Skeletal uptake of radiotracer, expressed as bone-to-soft-tissue ratio, was significantly higher in the osteomalacic patients than in a group of 80 controls.