Renal osteodystrophy

Changed by Henry Knipe, 21 Apr 2015

Updates to Article Attributes

Body was changed:

Show markup changes

Renal osteodystrophy (ROD), also known as uraemic osteopathy, 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~~: abnormal calcium and phosphate metabolism)
- bone resorption
- osteosclerosis
- soft tissue &and vascular calcifications
- brown tumours
aluminum intoxication, e.g. if the patient is on dialysis

Radiographic features

Imaging findings are many and varied:

osteopaenia: (often seen early) thinning of cortices and trabeculae
salt and pepper skull
~~demineralization~~demineralisation: usually subperiosteal, however it may also involve joint margins, endosteal, subchondral, subligamentous areas, cortical bone or trabeculae ⁵
subperiosteal resorption: characteristic subperiosteal resorption may be seen on radial aspects of middle phalanges of index and long fingers.
bone sclerosis
- rugger-jersey spine: sclerosis of the vertebral body end plates
soft tissue calcification
amyloid deposition: erosion in and around joint
insufficiency fractures
Looser's zone
Brown tumours

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

~~-<a href="/articles/osteomalacia">osteomalacia </a>(adults)/<a href="/articles/rickets">rickets</a> (children)</li>~~
~~-<li>secondary <a href="/articles/hyperparathyroidism">hyperparathyroidism</a> (abnormal calcium and phosphate metabolism)<ul>~~
+<a href="/articles/osteomalacia">osteomalacia </a>(adults) / <a href="/articles/rickets">rickets</a> (children)</li>
+<li>secondary <a href="/articles/hyperparathyroidism">hyperparathyroidism</a>: abnormal calcium and phosphate metabolism<ul>
~~-<li>soft tissue & vascular calcifications</li>~~
+<li>soft tissue and vascular calcifications</li>
~~-<li>demineralization: usually subperiosteal, however it may also involve joint margins, endosteal, subchondral, subligamentous areas, cortical bone or trabeculae <sup>5</sup> </li>~~
+<li>demineralisation: usually subperiosteal, however it may also involve joint margins, endosteal, subchondral, subligamentous areas, cortical bone or trabeculae <sup>5</sup> </li>
~~-<li>soft tissue calcification</li>~~
~~-<li>amyloid deposition: erosion in and around joint</li>~~
~~-<li>insufficiency fractures</li>~~
+<li><a href="/articles/periarticular-soft-tissue-calcification">soft tissue calcification</a></li>
+<li>
+<a href="/articles/amyloid-arthropathy">amyloid deposition</a>: erosion in and around joint</li>
+<li><a href="/articles/insufficiency-fracture">insufficiency fractures</a></li>

Tags changed:

renal

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":4882,"studyId":37614,"caseSlug":"subperiosteal-resorption-1","caption":"Case 1: subperiosteal resorption","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/4882/806f3fcd6eabba6238d1de5e4192f4_big_gallery.jpeg"},{"imageId":455,"studyId":37447,"caseSlug":"rugger-jersey-spine-5","caption":"Case 2: rugger jersey spine","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/455/e2fe276842ef3935eb5db3e402f654_big_gallery.jpeg"},{"imageId":25122,"studyId":37911,"caseSlug":"renal-osteodystrophy-and-brown-tumours-1","caption":"Case 3: brown tumours","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/25122/a6c42785524f6f13e245e875040f99_big_gallery.jpeg"},{"imageId":49138982,"studyId":78030,"caseSlug":"brown-tumors-compressing-the-spinal-cord","caption":"Case 4: brown tumours compressing spinal cord","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/49138982/a4bd3d8237e1827cd6044afc284eb6_big_gallery.jpeg"},{"imageId":153797,"studyId":8741,"caseSlug":"renal-osteodystrophy-hand","caption":"Case 5","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/153797/1f666a7fe4adda9dc1de4b4f224c75_big_gallery.jpg"},{"imageId":447842,"studyId":10289,"caseSlug":"brown-tumours","caption":"Case 6: brown tumours","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/447842/d886f1987f8a252272185d25933bac_big_gallery.jpg"},{"imageId":498600,"studyId":10683,"caseSlug":"renal-osteodystrophy-3","caption":"Case 7","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/498600/5e89adbb2652e7f93a38716d55ec1a_big_gallery.jpg"},{"imageId":530242,"studyId":10871,"caseSlug":"renal-osteodystrophy-4","caption":"Case 8","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/530242/818ee4cf57faffa23ac29fae2dd107_big_gallery.jpg"},{"imageId":627660,"studyId":12784,"caseSlug":"renal-osteodystrophy-with-widespread-soft-tissue-calcification","caption":"Case 9: soft tissue and ligament calcification","isStack":false,"diagnosticCertainty":"probable","thumbnail":"https://prod-images-static.radiopaedia.org/images/627660/8e4823daa51df2f0352228e9b4bb09_big_gallery.jpg"},{"imageId":564307,"studyId":11547,"caseSlug":"amyloid-arthropathy","caption":"Case 10: amyloid arthropathy","isStack":false,"diagnosticCertainty":"possible","thumbnail":"https://prod-images-static.radiopaedia.org/images/564307/4962aaa265afdb78b2e21ac1d1aaa0_big_gallery.jpg"},{"imageId":3365251,"studyId":22965,"caseSlug":"secondary-hyperparathyroidism","caption":"Case 11: osteosclerosis and multiple lytic lesions of bone resorption","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/3365251/dd63212a74bd718be14c8f57e6e6d7_big_gallery.jpg"},{"imageId":8070937,"studyId":31407,"caseSlug":"renal-osteodystrophy-of-the-skull-vault","caption":"Case 12: salt and pepper skull","isStack":false,"diagnosticCertainty":"probable","thumbnail":"https://prod-images-static.radiopaedia.org/images/8070937/a75cff78aad8a6f693a598f2390b79_big_gallery.jpg"},{"imageId":10973077,"studyId":35496,"caseSlug":"renal-osteodystrophy-of-the-skull-vault-1","caption":"Case 13: salt and pepper skull","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/10973077/5e604419204e3ad076984df9e9f5d3_big_gallery.jpg"},{"imageId":11967115,"studyId":36923,"caseSlug":"renal-osteodystrophy-7","caption":"Case 14","isStack":false,"diagnosticCertainty":"probable","thumbnail":"https://prod-images-static.radiopaedia.org/images/11967115/3c834f1cceb4aa7cea1a88b34b143c_big_gallery.jpg"},{"imageId":35093253,"studyId":64677,"caseSlug":"renal-osteodystrophy-14","caption":"Case 15: rugger jersey spine","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/35093253/6bc1e48e2caac83c2d17e5733adbcc_big_gallery.jpeg"},{"imageId":36732887,"studyId":66092,"caseSlug":"renal-osteodystrophy-15","caption":"Case 16","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/36732887/4f22496d18e3a8b4b25dfac5938bc3_big_gallery.jpeg"},{"imageId":51217180,"studyId":80266,"caseSlug":"renal-osteodystrophy-18","caption":"Case 17: with forearm AVF","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/51217180/854c26971afbc4eb9013d7a53743eb_big_gallery.jpeg"},{"imageId":53500530,"studyId":96157,"caseSlug":"hyperparathyroidism-5","caption":"Case 18: soft tissue calcification and acro-osteolysis","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/53500530/1b3020c03b2116725f55c3cce1461fe9d6eab3ab6c228ec755c0d189b7a2cdbe_big_gallery.jpeg"},{"imageId":62821389,"studyId":138762,"caseSlug":"brown-tumour-8","caption":"Case 19: brown tumour of the left maxilla","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/62821389/fda33a9400e745b7540c2f684819b9ddcd35bae3876ac3d25991b8bcb9d609a9_big_gallery.jpeg"},{"imageId":64073388,"studyId":144098,"caseSlug":"sacroiliac-erosions-and-subperiosteal-resorption-from-renal-osteodystrophy","caption":"Case 20: SIJ erosions and subperiosteal resorption","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/64073388/993c606af5237dddff89b59ded5e3d4d530b6ef3d52cc530a3bb7c1f44840646_big_gallery.jpeg"}],"ddx_inclusions":[{"imageId":1197353,"studyId":14139,"caseSlug":"multiple-myeloma-6","caption":"Multiple myeloma","isStack":true,"diagnosticCertainty":"probable","thumbnail":"https://prod-images-static.radiopaedia.org/images/1197353/d6623153017f799bc7801c25411fcc_big_gallery.jpg"}],"lang":"gb"}