Metabolic bone disease is the third most common endocrine disorders after diabetes and thyroid diseases. The common metabolic bone diseases (MBD) include osteoporosis, rickets/ osteomalacia, flurosis and primary hyperparathyroidism (PHPT), while the rare MBDs include Paget's disease, tumor induced osteomalacia, fibrous dysplasia, osteogenesis imperfecta and so on.

When symptoms are present, localized bone pain is the usual complaint. Due to high vascularity of the bone lesions, there may be warmth to the overlying skin compared to other areas. Lesions near joints may cause joint deformation and arthritic pain, and severe deformity of long bones may cause gait abnormalities, which contribute to joint pain. In addition, bony lesions in the vertebrae may cause pain or neurologic symptoms due to compression on the spinal cord or on nerve roots. Pathologic fractures may occur through PDB lesions, especially in the femur.