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. 2021 Mar 18;110(5):592–604. doi: 10.1007/s00223-021-00836-1

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 2 — Local deterioration of bone mass after fracture and subsequent unilateral disuse of the right limb. a Cone-beam computed tomography (CBCT) images of the right foot compared to the left foot (coronal and sagittal reconstruction) in a 22-year-old female patient obtained eight months after suffering from an ankle fracture with subsequent unilateral unloading of the right limb. Focal osteolytic changes (often referred to as “local disuse osteopenia/osteoporosis”) are visible. b DXA scans demonstrating the differences in BMD between the right and left proximal femur (T-score − 2.6 vs. − 1.5). Bilateral HR-pQCT scans of the distal tibiae were also performed and showed cortical and trabecular bone loss syndrome on the unloaded side compared to the contralateral (loaded) side (cortical thickness − 28%, bone volume per tissue volume − 7%)