Introduction 1 2 3 4 5 Technical aspects of whole-body MRI 6 7 8 9 Technical aspects of whole-body CT 10 11 12 Multislice CT enables bone destruction to be detected as well as osteoblastic and mixed patterns with osteosclerosis and destruction. In cases of diffuse bone marrow infiltration inhomogeneous osteoporosis may be detected. However, as in radiography, this may mimic osteoporosis, unless areas of bony destruction are present. 3D reconstruction algorithms, like VRT (volume rendering technique), can be used to display complex fractures (e.g., pathological fracture) and further increases the reliability to detect occult vertebral fractures compared with plain radiographs. Furthermore, the 3D morphology of vertebral fractures may give indications concerning the nature of the fracture (e.g., tumorous vs. osteoporotic fracture). Clinical application of whole-body MRI 1 13 31 16 17 18 19 Fig. 1 a arrow b arrow arrowheads arrowhead c d e arrow  f  g  Metastasis 20 2 21 22 23 Whole-body MRI compared with bone scintigraphy 99m 24 6 24 25 6 20 3 Interestingly, both methods showed differences in performance according to lesion location. Most false-negatives in scintigraphy were found in the spine, while diagnostic problems for WB-MRI occur in the thoracic cage and skull, especially when coronal imaging orientation is used, a problem that is certainly increased by motion artefacts. These problems might be overcome when using fast turbo spin echo sequences for thoracic imaging in combination with axial slice orientation. Whole-body MRI compared with MS-CT 10 26 1 27 Whole-body MRI compared with PET-CT 28 29 14 30 15 31 31 1 2 32 Fig. 2 a b c d e  33 99m 30 An important indication in bone imaging is lesion monitoring after chemotherapy or radiation therapy. It has to be taken into account that on MRI necrotic bone metastases may remain virtually unchanged in morphology or signal characteristics, which may make evaluation of therapy response difficult. Compared with viable tumors, the contrast enhancement is frequently less pronounced and slower in tumors that have responded to a particular therapy. Reduction in tumor size may be delayed and is not a sensitive sign in the assessment of response. Tumor metabolism, and consequently FDG uptake, is highly susceptible to chemotherapy. On the CT image, osteolytic metastases often demonstrate typical sclerotic transformation. In this setting, future studies are needed to evaluate the sensitivity of FDG-PET-CT in assessing the response to chemotherapy and whether sensitivity is reduced in the first days after initiation of therapy. After radiation therapy MRI is particularly helpful, because irradiated lesions are easily distinguishable from new lesions because of the high signal of normal bone marrow on T1-weighted SE images, which is due to conversion of hematopoietic into fatty bone marrow. Multiple myeloma 3 Fig. 3 a b arrow c arrow d e f g  34 2 35 36 37 38 16 39 17 3 40 Muscle disease 41 41 42 4 Fig. 4 a b c d e  18 19 However, assessment of distal parts of the upper extremity may be limited. This is due to positioning of the arms on the pelvis and thighs. If the muscles of the forearm are in the focus of interest, additional examination with dedicated coil systems may be required. 43 Future applications 44 45 5 Fig. 5 a b c d e  Conclusion Whole-body imaging is increasingly successfully applied in musculoskeletal imaging, especially in the field of systemic malignant diseases affecting the bone and in diseases predisposing to malignant transformation. Whole-body MRI is able to depict bone marrow pathologies with high resolution and excellent soft tissue contrast by demonstrating signal alterations due to changes in its fat, water, and hematopoietic cell components with high resolution and excellent soft tissue contrast. Together with CT or PET-CT and its valuable additional metabolic information, it has great potential in the more comprehensive, more accurate, and earlier diagnosis of musculoskeletal diseases. Although further evaluation of the true potential of whole-body applications is awaited, they are promising tools aiding the more efficient management of patients suffering from systemic malignant or benign diseases of the soft tissue and bone.