Osteomalacia is a rare and harmless osteosclerotic disease, also known as diffuse dense (or concentrated) bone disease, familial diffuse osteosclerosis, and punctate bone, which may run in families and can be clinically asymptomatic, usually found incidentally on X-ray, seen at any age, more in males than females, and generally negative on laboratory tests, with normal blood calcium and phosphorus. So how is the disease detected by imaging? The radiographic manifestations of osteomalacia are most commonly seen in the epiphysis and epiphysis of tubular bones, rarely in the diaphysis, and also in the pelvis. The vertebrae, skull and mandible are rarely affected. Typically, there are a variable number of nodular, round, oval, or striated dense shadows scattered in the cancellous bone of the epiphysis and metaphysis, with the long axis parallel to the long axis of the bone. In the iliac and scaphoid bones, they are arranged radially, centered on the acetabulum and articular glenoid. The spots are 2mm-2cm in size, with smooth or irregular margins. The central part of the spots may be translucent. The bone cortex, bone contour and joints are normal, the periosteum and articular cartilage are not invaded, the joint surface is smooth and the gap is well-proportioned. After growth and development have ceased, the lesions generally do not change, but sometimes they may disappear or new lesions may appear.