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Renal osteodystrophy - hand

Case contributed by Hani Makky Al Salam
Diagnosis almost certain
x-ray

There is decreased bone density of hand and wrist, with subperiosteal resorption in the radial aspect of the phalanges. There are partly healing deformed distal ulna and radius fractures with medial angulation at the distal parts of radius suggestive of partially healing insufficiency fractures complicating renal osteodystrophy associated with secondary hyperparathyroidism.

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