IMPROVED ROENTGENOLOGIC DIAGNOSIS OF OSTEOMALACIA BY MICRORADIOSCOPY OF HAND BONES

Abstract

Microradioscopic study of metacarpals in 24 osteomalacic and 3� osteoporotic patients revealed excessive intracortical resorption (striations) in approximately 6o percent of patients suffering from osteomalacia, but in none of the osteoporotics. Phalangeal periosteal resorption was found less frequently in osteomalacia than metacarpal striations, and was absent in osteoporotics. On the other hand, quantita- tive evaluation of cortical thickness, percent cortical area, bone mineral mass, and density did not show any clear differences between the two study groups. It is con- cluded that the differential diagnosis between osteomalacia and osteoporosis may be considerably improved by microradioscopy of hand bones. \ATE have previously shown that the use V V of industrial (fine-grain) roentgeno- graphic films and a simple magnification procedure, microradioscopy, enabled detec- tion of abnormal intracortical resorptive changes ("tunnels," "cutting cones")" in the metacarpal bones in seven of ten female patients suffering from vitamin D defi- ciency osteomalacia.'7 We have now ex- amined additional cases of osteomalacia and the findings will be compared to those obtained in a group of patients suffering from severe osteoporosis. The results mdi- cate that the study of intracortical and periosteal resorptive changes by micro- radioscopy is a useful adjunct to the roent- genologic differential diagnosis between osteoporosis and osteomalacia. MATERIAL AND METHOD