 X @-@ rays may also be used to diagnose the disease . Usually , these X @-@ rays will show extremely thin bones , which are often bowed or fractured . However , such symptoms are also associated with other bone diseases , such as osteopenia or osteoporosis . Generally , the first bones to show symptoms via X @-@ ray are the fingers . Furthermore , brown tumors , especially when manifested on facial bones , can be misdiagnosed as cancerous . Radiographs distinctly show bone resorption and X @-@ rays of the skull may depict an image often described as " ground glass " or " salt and pepper " . Dental X @-@ rays may also be abnormal . 
