[Questions from clinicians to the radiologist regarding the diagnosis of metabolic bone diseases].

Macromorphological X-ray findings in metabolic bone disease can establish the diagnosis only in advanced stages. Micromorphological X-ray diagnostic procedures will support the diagnosis even at an early stage. Measurement of minerals is an adjuvant method for early diagnosis and survey of therapy in metabolic bone diseases. The measurement of calcium phosphate metabolism and description of bone histology (histomorphometry) and radiological morphology enables the type and stage of osteopathy to be diagnosed. The combination of diagnostic methods is helpful in distinguishing bone diseases with increased turnover, impaired bone modelling and absorption, disturbed mineralization and ectopic calcification. Within the metabolic osteopathies, osteoporosis is gaining importance as a socioeconomic problem; therefore, early diagnosis and treatment are of relevance. Hyper-, hypoparathyroidism and osteoidosis are curable if early diagnosed.