Radiographic Synopsis

1. Osteoporosis, decreased number of trabeculae, 'coarse' trabecular pattern; radiolucent areas in the cortex; widened metaphyses; deossification and unsharpness of epiphyseal centers; bowing of long bones (osteomalacia, rickets)

2. Areas of increased bone density; osteosclerotic foci around the cartilaginous end-plates in the spine; periarticular and vascular calcification (osteomalacia, especially accompanying renal osteodystrophy)

3. Growth plate changes (often mild); bowing of long bones, especially in the extremities; mild osteope-nia (X-linked hypophosphatemia, children). Coarsened trabecular pattern; Looser's zones; pseudo-

fractures; elevated bone density; 'paradoxical' calcification and ossification of ligaments, tendons at their osseous insertion, annulus fibrosus, joint capsules, and ligamentum flavum, with narrowing of the spinal canal; osteoarthritis (X-linked hypophosphatemia, adults)

4. Femoral bowing; diffuse metaphyseal flaring; irregularity and widening of the growth plate, most pronounced at knees; enlarged capital femoral epiphyses; severe coxa vara; anterior cupping, splaying and sclerosis of the ribs; marked lumbar lordosis (metaphyseal dysplasia, Schmid type)

5. Anterolateral angulation of femurs; anterior angu-lation and shortening of tibias; hypoplastic fibulas; mild shortening and bowing of forearms (campomelic dysplasia)

6. Short, broad, and bowed femurs with irregular, flared metaphyses; shortening and bowing of other tubular bones, especially the humeri (kypho-melic dysplasia)

7. Lacy appearance of the iliac crests; 'flocky' or 'woolly' metaphyseal appearance; severe epiphy-seal deformation (parastremmatic dwarfism)

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