Histopathologic changes in metabolic bone disease.

Metabolic bone disease encompasses a heterogeneous group of disorders that influence skeletal metabolism and structure. They are generally diagnosed at an advanced stage and manifest clinically with stunted skeletal growth in children and pathologic fractures in adults. Biochemical markers for bone metabolism are equivocal and microscopic examination of labeled bone remains the gold standard for the diagnosis and accurate monitoring of the response to therapy. This article reviews the role of microscopic bone changes in the diagnosis and management of metabolic bone disease.