Osteomalacia is a disease in which normal bone tissue is replaced by abnormally proliferated fibrous tissue. It occurs under the age of 30, and more than 80% of the patients show deformed swelling of the diseased bone area. It can cause nasal congestion, decreased sense of smell, facial asymmetry, protruding and displaced eyeballs, diplopia, visual impairment and difficulty in opening mouth. Pathological fractures and malignant changes can occur in this disease. Radiographic manifestations: a. Cystic swelling changes. It can be unicystic or multicystic swelling with clear and slightly sclerotic margins, and longitudinal striated or speckled dense shadow is often seen inside and outside the capsule without periosteal hyperplasia. b. Hairy glass-like changes. Mostly seen in long tubular bones and ribs, mainly refers to the uniform increase of density in cystic swelling changes into hairy glass, which is the characteristic change of this disease. c. Silicon-flesh-like changes. Commonly found in ribs, femur and humerus. The affected bone is swollen and thickened, the cortex becomes thin or even disappears, and the bone trabeculae are coarse and distorted, showing a coarse bone texture that travels in the longitudinal direction. d. Worm-like changes. It can coexist with lenticel-like changes, and the disease becomes multiple punctate osteolytic bone destruction with sharp edges like worm devouring, which is sometimes difficult to distinguish from osteolytic metastases. e. Sclerotic changes. It is more common in adults, commonly in the ribs, and less common in long tubular bones.