Thus, the initial assessment of plain radiographs and correlating them with MRI/CT is vital to assist in diagnosing metabolic bone diseases. Even though the baseline radiographs are available at the time of advance imaging evaluation, most of the time, they are overlooked by reporting radiologists and treating physicians and eventually, patients returned to clinics with non-specific MRI/CT reporting without a specific diagnosis. Often, they do not have plain radiographs at the time of the initial interpretation of cross-sectional imaging. Patients often present to orthopedic or rheumatology clinics with non-specific back pain, generalized ache, and arthralgia mimicking degenerative diseases of the spine or spondyloarthropathies, and undergoing MRI of spine or sacroiliac (SI) joint or pelvis. With the ability to better evaluate slight alteration in bone density, subtle bone resorption, new bone formation, and incomplete/insufficiency fracture, plain radiography scores over magnetic resonance imaging (MRI) or computed tomography (CT) for the assessment of metabolic bone conditions. Plain radiography is a mainstay in the diagnostic armamentarium for assessing bone diseases. Therefore, the objective of our paper is to present a systematic approach to the interpretation of plain radiographs of the pelvis, spine, and chest that can facilitate identifying subtle imaging findings supported by complementary other region plain radiographs and laboratory data for the evaluation of metabolic bone diseases. A variety of radiographic findings is encountered in metabolic bone diseases, though often subtle, is unceasingly diagnostic, and recognition of these findings leads to early diagnosis and treatment, resulting in improved patient outcomes. Although basic radiographs are frequently available at the time of MRI, it is often ignored by both the radiologists and clinicians who can lead to misdiagnosis or missed diagnosis. Thus, the importance of plain radiographs is neglected. In this era of advanced imaging technologies, magnetic resonance imaging (MRI) is increasingly being requested by clinicians as an initial investigation for the non-specific presentation of metabolic bone conditions, including back pain, generalized weakness, and arthralgias, and is usually largely non-contributory. Although the metabolic bone diseases are fairly commonly encountered in routine practice in India, unfortunately, the clinical presentation is quite non-specific and often remains unrecognized for years, leading to increased morbidity.

Normal hip socket margins o0n xray