Abstract
In the majority of cases, artefacts, calcifications of the damaged ligamentous apparatus or degenerative changes (spondylophytes) are causes of increased bone density values of the vertebral body in the DXA measurement. In these cases, comparison with the measurements of the hip or with an X-ray of the lumbar spine quickly brings clarification. When artefacts, calcifications, degenerative reactions and especially a measurement error are excluded, further clinical, radiological, laboratory and biopsy investigations of the diagnosis “increased bone density” are required. These may be generalised, multifocal or local, they can be painful or accidentally discovered, they can be congenital or acquired, and they may have completely different causes: inflammatory, toxic, medical, neoplastic or metabolic. Bones with increased bone density do not correlate with higher strength, and there is even an increase in fracture risk due to loss of elasticity and abnormal bone modelling. Caused by irritation of endosteal and periosteal afferent nerve fibres, there may be a dull bone pain.