Renal osteodystrophy

Changed by Savitha Srirama Jayamma, 20 Sep 2014

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Renal osteodystrophy (ROD) is the constellation of musculoskeletal abnormalities that occur in patients with chronic renal failure, due to concurrent and superimposed:

osteomalacia (adults) / rickets (children)
secondary hyperparathyroidism (abnormal calcium and phosphate metabolism)
- bone resorption
- osteosclerosis
- soft tissue & vascular calcifications
- brown tumours
aluminum intoxication, e.g. if the patient is on dialysis
This condition is also known as uremic osteopathy.

Radiographic features

Imaging findings are many and varied :

osteopaenia : often seen early
thinning of cortices and trabeculae
salt and pepper skull
subperiosteal resorption : characteristic subperiosteal resorption may be seen on radial aspects of middle phalanges of index and long fingers.
rugger-jersey spine : sclerosis of the vertebral body end plates
demineralization : usually subperisosteal, however it may also involve joint margins, endosteal, subchondral, subligamentous areas, cortical bone or trabeculae⁵
soft tissue calcification
amyloid deposition : erosion in and around joint
fractures

Differential diagnosis

osteomalacia
rheumatoid arthritis
seronegative spondyloarthropathies
neoplasms - multiple myeloma, metastases; brown tumours can mimic primary malignant tumour of bone; amyloid deposition may mimic PVNS or synovial chondromatosis
Infections
occult marrow abnormalities

+<li>This condition is also known as uremic osteopathy.</li>

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