Musculoskeletal abnormalities: A clue to systemic diseases

Musculoskeletal abnormalities are a frequent yet often underrecognized manifestation of systemic disease and may precede visceral involvement, clinical symptoms, or specific laboratory abnormalities. Recognizing characteristic musculoskeletal imaging patterns can provide an important diagnostic clue and prompt investigation of an underlying systemic condition. This review outlines key imaging findings of selected systemic disorders that commonly present with skeletal or soft-tissue involvement, grouped by etiology into metabolic and deposition, inflammatory, infectious, hematologic/histiocytic, and hereditary tumor syndromes. Emphasis is placed on imaging features that may suggest systemic disease, important differential diagnoses, and findings that should prompt further clinical and laboratory evaluation. By recognizing these musculoskeletal abnormalities as potential markers of systemic pathology, radiologists may contribute to earlier diagnosis, reduce diagnostic delay, and directly influence multidisciplinary management and treatment decisions.