34 patients with skeletal alterations mostly in the periphery were investigated by digital image intensifier radiography (DIIR). A high resolution image-intensifier system (1024 x 1024 matrix, 40 cm, 28 cm, 14 cm image intensifier, maximal spatial resolution: 3.6 lp/mm) was available. The image quality was diagnostic sufficient in 76% using DIIR. A good or very good image quality of fine-structures was obtained only in 41%. The quality deficits in comparison to conventional radiograms were particularly obvious in investigation of the phalangeals. Logarithmic amplification and software upgrading lead after these first clinical investigations to a better image quality.