Foreword

Metabolic bone disease includes hormone and endocrine imbalances as well as osteomalacia and osteoporosis. These are extremely complicated disorders requiring an understanding of biochemistry and physiology. Consequently many radiologists cringe when these topics are discussed; they are, however, overwhelmingly important. The pathophysiology of bone touches on all spheres of musculoskeletal imaging.

Making the subject of metabolic bone disease more difficult is the historically similar imaging appearance of these disorders. Although not typically considered a component of advanced imaging, there have been tremendous advances in the last decade in the imaging of metabolic bone disease. This topic is well edited by the guest editor, Judith Adams, and is discussed in this issue (Part 1) and the next (Part 2) issue of Seminars in Musculoskeletal Radiology. The first article in Part 1 starts at the beginning, which is the pathophysiology of rickets and osteomalacia. The subsequent articles cover these and related topics, such as osteoporosis, in more detail before proceeding to advanced imaging techniques, including DEXA, QCT, and to the more recent quantitative ultrasound technique. The last three topics are linked to each other and to the imaging of trabecular bone structure. This may be the future of physiologic imaging of bone and represents the nexus between anatomy and physiology.

The authors of this issue have done a superb job of dealing with a very complicated topic. Judith Adams is a world-renowned musculoskeletal radiologist, and has had a special interest in metabolic bone disease for many years. In these two issues, Dr. Adams has gathered an impressive list of authors and comprehensive topics; we commend her on a job well done.