Radiologic study of endosteal, intracortical, and periosteal surfaces of hand bones in metabolic bone diseases

In metabolic bone diseases, subtle abnormalities occur on the three surfaces of bone, the recognition of which is important for diagnosis, as well as in follow-up studies, to recognize progression or regression. These resorptive and formative changes are best studied in fine-detail hand radiographs under 6 to 8 times magnification by a relatively simple radiologic method (microradioscopy). The periosteal resorption of hyperparathyroidism is thus recognized earlier than by regular radiography, and intracortical resorption, not detectable by the naked eye, can be visualized. The latter is also seen frequently in nutritional osteomalcia, renal osteodystrophy, and thyrotoxicosis, and sometimes in acromegaly. Endosteal resorption in developing involutional osteoporosis can also be recognized more efficiently by microradioscopy than by ordinary radiographs without magnification. Fine-detail hand radiographs may thus be used as an inexpensive preliminary measurement for diagnosis of osteoporosis.