Abstract
This article concentrates on generalized disorders causing bone fragility. The most
frequent cause of brittle bone disease is osteoporosis, only diagnosed by elimination.
First, malignant osteopathy must be ruled out: fracture on metastasis or multiple
myeloma, which mimics osteoporosis when presenting as diffuse demineralization. Second,
patients should be screened for signs of hyperparathyroidism or osteomalacia. Much
more rarely, many other pathologies can lead to brittle bone by demineralization or
associated increased bone density.
The radiologist needs to know the clinical context and notably the patient's age (childhood
or adulthood) at discovery, and known pathologies and ongoing or previous treatments:
corticotherapy, bisphosphonates, denosumab, or prior radiotherapy in the affected
region. Diagnostic hypotheses are guided by the type of demineralization and the presence
of lytic, mixed, or densifying areas. Lastly, the aspect and location of fractures
and association with other bone abnormalities refine the diagnosis.
Keywords
brittle bone - osteoporosis - malignant osteopathy - hyperparathyroidism - osteomalacia
