Improved Radiological Diagnosis of Azotemic Osteodystrophy

Abstract

Radiological and histological (iliac crest biopsy) studies were performed concurrently in 16 nondialyzed and 16 hetnodialyzed patients with severe chronic renal disease. Radiological examination included skeletal survey, magnified viewing (8×) of fine-grained radiographs of the hand, and densitometric measurement of bone mineral mass and density in the radius. On histological examination, the incidence of osteitis fibrosa was 82% and osteomalacia 84%, while radiological evidence of bone loss was found in 73% of the examinations. The commonest radiological abnormality was subperiosteal resorption of the phalanges (50%), followed by decreased bone mineral density (47%) and mass (32%).