III. Ulnar Bone Mineral Concentration in Metabolic Bone Diseases

Abstract

This paper deals with the measurement of bone mineral concentration in the distal third of the ulna in patients suffering from a variety of diseases, all of which affect in some way the bony skeleton. These diseases are somewhat loosely described as metabolic bone diseases. For convenience, osteoporosis of unknown cause is included in this group. In most instances, the whole of the bony skeleton is presumed to be affected by these diseases, but not all bones and not all parts of one bone need be equally or even similarly affected. For all practical purposes, there are only three kinds of abnormality encountered in metabolic bone diseases, osteomalacia, osteoporosis and osteosclerosis. The paper by Nordin and Barnett (1961) has clearly illustrated the fundamental distinction between osteomalacia and osteoporosis. Osteosclerosis can be defined in similar terms. Osteoporosis and osteomalacia both result in a reduced mineral content per unity volume of bone. At any one site in any one bone it is not possible by radiological methods to specify whether a reduction in bone mineral concentration is due to osteomalacia, to osteoporosis or to both. This is not to deny the existence of radiological criteria of osteomalacia, or the possibility that there may be radiological criteria of osteoporosis, but these criteria are relatively crude and may require radiological survey of many parts of the skeleton for their demonstration.