[Extrahepatic manifestations of liver diseases: skeleton]

Since nowadays liver diseases are being diagnosed more frequently than in former years, an increasing number of patients with skeletal alterations is detected. Predominant is osteoporosis with the feared complications of bone fractures. The measurement of bone mineral density enables us to differentiate between normal, osteopenic and osteoporotic conditions. Despite the great number of data available on bone disease we are still incapable to predict which patients with liver disease will develop osteoporosis or bone fractures and when. Treatment should focus on the prevention of development of osteoporosis and fractures and rather not on the treatment of complications. We are still lacking convincing long-term treatment studies with a sufficient number of patients who are well stratified.