Metabolic bone disease: a review and update.

Understanding the structure and formation of bone and the metabolic diseases that cause intrinsic biochemical alterations and ultimate damage to the skeletal system is an essential part of orthopaedic education and knowledge. Metabolic bone diseases such as rickets, osteomalacia, renal osteodystrophy, hyperparathyroidism, and osteoporosis often lead to subtle alterations in the patient's clinical status and to severe and disabling changes in the patient's bone structure. It is essential that orthopaedists recognize these conditions, provide a correct diagnosis, and use appropriate preventive and therapeutic treatments.