Renal osteodystrophy and brown tumors

Case contributed by Frank Gaillard

Presentation

Chronic renal failure.

Patient Data

Age: Adult
Annotated image

Plain X-ray hands of a young patient with CRF shows signs of secondary hyperparathyroidism:

  • irregular, frayed and ill-defined cortical outline, pronounced at radial aspect of middle phalanges –> subperiosteal bone resorption
  • multiple lytic expansile lesions –> brown tumors (arrows)
  • osteosclerosis
  • accentuated trabecular pattern non-essential trabeculae are resorbed; those that remain appear prominent)

Case Discussion

Renal osteodystrophy is a constellation of musculoskeletal abnormalities that occur in patients with chronic renal failure.

Manifestations include:

Comment: Subperiosteal bone resorption is the hallmark of HPTH and is first identified in hands.

Credit: Dr Ahmed Haroun

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