Lanthanum in the colon
Preoperative radiograph for kidney transplant. Name all the findings. Think what complications of chronic renal failure you see? Think what medications this patient may be on.
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A peritoneal dialysis catheter overlies the lower pelvis satisfactorily. Multiple radiopaque densities scattered throughout the colon, likely PICA and geophagia. These have increased in number on the 2 radiographs which are about one year apart.
Splenic calcified granulomas.
The right femur demonstrate postsurgical changes from previous core decompression of avascular necrosis of the right femoral head by a vascularised fibular graft. AVN both femoral heads.
Correlate with patient's history regarding Pica, and geophagia. Differential diagnosis: Lanthanum toxicity.
Chart review confirms the patient was on Lanthanum for hyperphosphatemia.
What is the atomic numbers for Barium and Lanthanum? That is why it looks like as dense as Barium.
So the importance of history and chart review for medications is made here.
- 1. Yoo MC, Kim KI, Hahn CS et-al. Long-term followup of vascularized fibular grafting for femoral head necrosis. Clin. Orthop. Relat. Res. 2008;466 (5): 1133-40. doi:10.1007/s11999-008-0204-9 - Free text at pubmed - Pubmed citation
- 2. Cerny S, Kunzendorf U. Images in clinical medicine. Radiographic appearance of lanthanum. N. Engl. J. Med. 2006;355 (11): 1160. doi:10.1056/NEJMicm050535 - Pubmed citation