{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T22:29:44Z","timestamp":1772231384062,"version":"3.50.1"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Musculoskelet Radiol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This article concentrates on generalized disorders causing bone fragility. The most frequent cause of brittle bone disease is osteoporosis, only diagnosed by elimination. First, malignant osteopathy must be ruled out: fracture on metastasis or multiple myeloma, which mimics osteoporosis when presenting as diffuse demineralization. Second, patients should be screened for signs of hyperparathyroidism or osteomalacia. Much more rarely, many other pathologies can lead to brittle bone by demineralization or associated increased bone density.<\/jats:p><jats:p>The radiologist needs to know the clinical context and notably the patient's age (childhood or adulthood) at discovery, and known pathologies and ongoing or previous treatments: corticotherapy, bisphosphonates, denosumab, or prior radiotherapy in the affected region. Diagnostic hypotheses are guided by the type of demineralization and the presence of lytic, mixed, or densifying areas. Lastly, the aspect and location of fractures and association with other bone abnormalities refine the diagnosis.<\/jats:p>","DOI":"10.1055\/s-0043-1769776","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T22:30:30Z","timestamp":1695681030000},"page":"439-450","source":"Crossref","is-referenced-by-count":1,"title":["Brittle Bone Imaging: Diagnostic Procedures in Adults"],"prefix":"10.1055","volume":"27","author":[{"given":"Catherine","family":"Cyteval","sequence":"additional","affiliation":[{"name":"Department of Radiology, CHU, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulina","family":"Szafors","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, CHU, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxime","family":"Pastor","sequence":"additional","affiliation":[{"name":"Department of Radiology, CHU, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"issue":"S 05","key":"ref1","first-page":"S517","article-title":"Epidemiology and risk factors for osteoporosis [in French].","volume":"25","author":"P Dargent-Molina","year":"2004","journal-title":"Rev Med Interne"},{"issue":"01","key":"ref2","first-page":"19","article-title":"Relations between trabecular bone mass and the configuration in the space of the trabeculae of bone. Histomorphometric study of a population of 145 osteoporotic women [in French]","volume":"55","author":"D Chappard","year":"1988","journal-title":"Rev Rhum Mal Osteoartic"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1148\/rg.315105712","article-title":"Integrated imaging approach to osteoporosis: state-of-the-art review and update","volume":"31","author":"G Guglielmi","year":"2011","journal-title":"Radiographics"},{"issue":"50","key":"ref4","first-page":"1797","article-title":"The various forms of osteoporosis and their treatment [in French]","volume":"119","author":"P Burckhardt","year":"1989","journal-title":"Schweiz Med Wochenschr"},{"issue":"01","key":"ref5","first-page":"1","article-title":"Discordance between spine and hip bone mineral density measurement using DXA in osteoporosis diagnosis: prevalence and risk factors [in French]","volume":"92","author":"M Younes","year":"2014","journal-title":"Tunis Med"},{"issue":"09","key":"ref6","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1002\/jbmr.5650080915","article-title":"Vertebral fracture assessment using a semiquantitative technique","volume":"8","author":"H K Genant","year":"1993","journal-title":"J Bone Miner Res"},{"key":"ref7","first-page":"113","article-title":"Clinical variability in osteogenesis imperfecta-variable expressivity or genetic heterogeneity","volume":"15","author":"D O Sillence","year":"1979","journal-title":"Birth Defects Orig Artic Ser"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1359\/jbmr.2002.17.1.30","article-title":"Osteogenesis imperfecta type VI: a form of brittle bone disease with a mineralization defect","volume":"17","author":"F H Glorieux","year":"2002","journal-title":"J Bone Miner Res"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1148\/rg.2016160004","article-title":"Imaging findings of metabolic bone disease","volume":"36","author":"C Y Chang","year":"2016","journal-title":"Radiographics"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1055\/s-0036-1592429","article-title":"Metabolic bone disease in patients with malabsorption","volume":"20","author":"C M Phan","year":"2016","journal-title":"Semin Musculoskelet Radiol"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.crad.2004.04.021","article-title":"Magnetic resonance imaging in osteomalacic insufficiency fractures of the pelvis","volume":"60","author":"K Kanberoglu","year":"2005","journal-title":"Clin Radiol"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/S1297-319X(00)00238-4","article-title":"Adult hypophosphatasia. Current aspects","volume":"68","author":"D Wendling","year":"2001","journal-title":"Joint Bone Spine"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1148\/radiology.171.2.2539609","article-title":"X-linked hypophosphatemia in adults: prevalence of skeletal radiographic and scintigraphic features","volume":"171","author":"D C Hardy","year":"1989","journal-title":"Radiology"},{"key":"ref15","first-page":"1720","article-title":"Hereditary hypophosphatemia in adults [in French].","volume":"34","author":"F L V\u00e9layoudom-C\u00e9phise","year":"2005","journal-title":"Presse Med"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1148\/radiology.172.1.2740506","article-title":"Vertebral compression fractures: distinction between benign and malignant causes with MR imaging","volume":"172","author":"W T Yuh","year":"1989","journal-title":"Radiology"},{"issue":"05","key":"ref17","first-page":"330","article-title":"Musculoskeletal images. Early bone changes in hyperparathyroidism detected on magnetic resonance imaging","volume":"42","author":"C Gerrand","year":"1999","journal-title":"Can J Surg"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/MAJ.0000000000000441","article-title":"Skeletal lesions in primary hyperparathyroidism","volume":"349","author":"Q Yang","year":"2015","journal-title":"Am J Med Sci"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.rdc.2010.09.002","article-title":"Parathyroid disease","volume":"36","author":"H Y Wen","year":"2010","journal-title":"Rheum Dis Clin North Am"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1016\/S0140-6736(21)00796-0","article-title":"Hyperparathyroidism shows its hand: findings of osteitis fibrosa cystica","volume":"397","author":"L Rivas-Prado","year":"2021","journal-title":"Lancet"},{"issue":"08","key":"ref21","first-page":"34","article-title":"Hyperparathyroidism in a fracture population","volume":"105","author":"G Lee","year":"2022","journal-title":"R I Med J (2013)"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1148\/radiographics.13.2.8460225","article-title":"Musculoskeletal manifestations of chronic renal insufficiency","volume":"13","author":"M D Murphey","year":"1993","journal-title":"Radiographics"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/sdi.12598","article-title":"Imaging in chronic kidney disease-metabolic bone disease","volume":"30","author":"A J Alexander","year":"2017","journal-title":"Semin Dial"},{"issue":"11","key":"ref24","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.3390\/genes13111965","article-title":"Spectrum of skeletal imaging features in osteopetrosis: inheritance pattern and radiological associations","volume":"13","author":"P Spinnato","year":"2022","journal-title":"Genes (Basel)"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1148\/rg.321115041","article-title":"Imaging features of therapeutic drug-induced musculoskeletal abnormalities","volume":"32","author":"H S Sidhu","year":"2012","journal-title":"Radiographics"},{"issue":"05","key":"ref26","first-page":"273","article-title":"The most frequent complications during long-term corticotherapy [in Polish].","volume":"42","author":"R Matusiewicz","year":"1989","journal-title":"Wiad Lek"},{"issue":"02","key":"ref27","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.21873\/invivo.12356","article-title":"Pelvic insufficiency fractures in cervical cancer after radiation therapy: a meta-analysis and review","volume":"35","author":"Y K Chung","year":"2021","journal-title":"In Vivo"},{"issue":"19","key":"ref28","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1056\/NEJMoa1001086","article-title":"Bisphosphonates and fractures of the subtrochanteric or diaphyseal femur","volume":"362","author":"D M Black","year":"2010","journal-title":"N Engl J Med"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jbmr.1998","article-title":"Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research","volume":"29","author":"E Shane","year":"2014","journal-title":"J Bone Miner Res"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2214\/ajr.162.1.8273699","article-title":"Endemic fluorosis of the skeleton: radiographic features in 127 patients","volume":"162","author":"Y Wang","year":"1994","journal-title":"AJR Am J Roentgenol"}],"container-title":["Seminars in Musculoskeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1769776.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T22:32:00Z","timestamp":1695681120000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1769776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":29,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2023,9,25]]},"published-print":{"date-parts":[[2023,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1769776","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1089-7860","1098-898X"],"issn-type":[{"value":"1089-7860","type":"print"},{"value":"1098-898X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}