Metabolic disease

In this chapter we consider diseases associated with vitamin C deficiency (scurvy), vitamin D deficiency (rickets and osteomalacia), and osteoporosis, together with hyperostosis frontalis interna and fluorosis. Using careful reading of primary clinical literature and information on the pathophysiology of bone augmented with data from documented medical collections each condition is discussed. Key macroscopic lesions found in adult and subadult skeletal remains are considered, alongside the radiological and histological appearance where appropriate. Prior to fracture there are no macroscopically visible lesions associated with osteoporosis, so measures of bone structure and integrity that can be used to evaluate the condition are reviewed.