Diffuse osteopenia and compression of multiple VB
Lytic and sclerotic metaphyseal bands

Leukemia
Bony Changes
Osteopenia
Metaphyseal lucent and sclerotic bands
Lytic bone lesions
Periostitis
Arthritic – ST swelling, effusion, juxtaarticular osteopenia
Other
HSM
LAD
***In Peds think ALL***
DDX Dense Metaphyseal Lines “DENSE LINES”
D vitamin intoxication
Elemental poisoning – Arsenic, heavy metal
Normal variant
Systemic illness
Estrogen to mother during pregnancy
Leukemia
Infection (TORCH), Idiopathic hypercalcemia
Never forget healed rickets
Early hypothyroidism
Scurvy, Syphilis, SSD
DDX Osteoporosis
Congenital –OI, homocystinuria
Idiopathic – juvenile, adult, postmenopausal
Nutritional
Endocrine – Cushing, hypogonadism, hyperthyroidism, hyperparathyroidism, acromegaly, Addison’s, DM, pregnancy, paraneoplastic syndrome
Renal osteodystrophy
Collagen vascular disease
Bone marrow replacement – leukemia/ lymphoma, Multiple Myeloma, Mets, marrow hyperplasia
Drug Tx- Heparin, MTX, steroids, ETOH, Dilantin, smoking
XRT
Local- Sundeck’s, Transient osteoporosis of hip, Regional migratory osteoporosis of lower extremities