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2011, Number 4

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Anales de Radiología México 2011; 10 (4)

Subcutaneous nodules in renal osteodystrophy. Usefulness of ultrasound

Chávez-Ruiz R, Guardiola FA, Moreno GJM, Fernández TJ, Flores GAE

Language: Spanish
References: 20
Page: 308-314
PDF size: 206.19 Kb.


ABSTRACT

Purpose. We present the case of a patient with chronic kidney disease, with typical and advanced manifestations of the disease. The findings from different imaging methods didactically show the spectrum of manifestations associated with renal osteodystrophy. A review of the literature is included.
Materials and method. Male patient age 5 years in whom pyelocaliceal ectasia and left hydroureter were detected in week 20 of pregnancy. At birth the patient was diagnosed with Down’s syndrome, hydronephrosis, bilateral hydroureter, and acute kidney failure. He has presented poor metabolic control, multiple internments, and operations due to urinary obstructions. He went for consultation at age 5 years due to difficulty breathing; physical examination detected painful subcutaneous nodules in the inter-scapulovertebral region and it was requested that the nodules be studied with ultrasound, leading to the start of evaluations with various imaging methods.
Results. The findings observed in the region of interest (and elsewhere) showed some of the classic signs of renal osteodystrophy.
Conclusion. We reviewed the classic literature on renal osteodystrophy and it was correlated with the radiological results of the case. The analysis was complemented with representative images obtained using the latest imaging methods. The radiologist stressed the need for knowledge of early manifestations and the importance of detecting them opportunely.


REFERENCES

  1. Liu SH, Chu H. Studies of Calcium and Phosphorus Metabolism With Special Reference To Pathogenesis and Effects of Dihydrotachysterol (A.T.10) and Iron. Medicine 1943;22:103-162.

  2. Ginzler AM, Jaffe HL. Osseous findings in chronic renal insufficiency in adults. Am J Pathol, 1941;17:293-302.

  3. Follis RH, JR. Skeletal changes associated with hyperthyroidism. Bull Johns Hopkins Hosp 1953;92:405-21.

  4. Follis RH, JR. Renal Osteomalacia and Osteitis Fibrosa in adults. Bull Johns Hopkins Hosp, 1943;72:232-241.

  5. Parsons LG. The Bone Changes Occurring in Renal and Coeliac Infantilism and their Relationship to Rickets: Part II. Coeliac Rickets. Archives of Disease in Childhood, 1927;2:198-211.

  6. Crawford T et al. Osteosclerosis associated with chronic renal failure. Lancet 1954;267:981-8.

  7. Hruska KA. Renal Osteodystrophy, in Goldman: Cecil Medicine. 2007;132.

  8. Combe C, et al. Kidney Disease Outcomes Quality Initiative (K/DOQI) and the Dialysis Outcomes and Practice Patterns Study (DOPPS): nutrition guidelines, indicators, and practices. Am J Kidney Dis 2004;44:39-46.

  9. Murphey MD et al. Musculoskeletal manifestations of chronic renal insufficiency. Radiographics 1993;13:357-79.

  10. Resnick D, NG. Parathyroid Disorders, in Diagnosis of Bonse and Joint Disorders, Saunders, Editor 1988;2219-2285.

  11. Sundaram M et al. Terminal phalangeal tufts: earliest site of renal osteodystrophy findings in hemodialysis patients. Am J Roentgenol 1979;133:25-29.

  12. Resnick D, L Deftos and J Parthemore. Renal osteodystrophy: magnification radiography of target sites of absorption. Am J Roentgenol 1981;136:711-714.

  13. Mankin HJ. Review Article Rickets, Osteomalacia and Renal Osteodystrophy. J Bone Joint Surg Am 1974;56:352-386.

  14. Kricun M and D. Resnick. Elbow abnormalities in renal osteodystrophy. Am J Roentgenol 1983;140:577-579.

  15. Mateo L. et al. Brown tumor of the cervical spine: a case report and review of the literature. Clinical Rheumatology 2011;30:419-424.

  16. Verlaan L. et al. Primary hyperparathyroidism and pathological fractures: a review. Acta Orthop Belg 2007;73:300-5.

  17. McCarley, P.B. and M. Arjomand. Mineral and bone disorders in patients on dialysis: physiology and clinical consequences. Nephrol Nurs J 2008;35:59-64.

  18. Jevtic V. Imaging of renal osteodystrophy. Eur J Radiol 2003;46:85-95.

  19. Hutchison AJ et al. Correlation of bone histology with parathyroid hormone, vitamin D3, and radiology in end-stage renal disease. Kidney Int 1993;44:1071-1077.

  20. Lagomarsimo E. et al. Chronic renal failure in pediatrics 1996. Pediatric Nephrology 1999;13:288-291.




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