Renal osteodystrophy

Case contributed by Abeer Ahmed Alhelali
Diagnosis almost certain

Presentation

Known of renal failure on peritoneal dialysis, presented with bilateral hip pain with progressive loss of ability to walk.

Patient Data

Age: 5 years
Gender: Female
x-ray

Tip of peritoneal dialysis catheter projected in the left lower quadrant. There is bilateral symmetrical resorption of the femoral epiphyses and femoral neck. A coarse trabecular pattern and osteomalacia of the proximal femora and pubic symphysis are in keeping with bone resorption due to secondary hyperparathyroidism.

X-ray from 1 year earlier

x-ray

Normal gas distribution with peritoneal dialysis catheter tip projected in the lower abdomen.

Normal appearance of both femoral epiphyses, femoral necks and pubis symphysis.

Case Discussion

Renal osteodystrophy is a musculoskeletal abnormality that occurs in patients with chronic renal failure - the most important cause is abnormal calcium and phosphate metabolism caused by secondary hyperparathyroidism. It presents radiologically with osteopenia and bone resorption, usually subperiosteal and in the radial aspect of long bones.

In our case, laboratory tests confirmed the diagnosis and appropriate treatment was initiated. 

Case submitted By Dr. Abeer Alhelali & Dr. Thuzar WIN.

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