renal osteodystrophy

Salt and

pepper sign (skull) • Renal osteodystrophy of the skull vault - Ganzer Fall bei Radiopaedia

Cuete, D. Renal osteodystrophy of the skull vault. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-34227 • CC by-nc-sa 3.0 (modified)

Renal

osteodystrophy: A 57-year-old female with end-stage renal disease which results in prominent subchondral resorption resulting in widening of bilateral sacroiliac joints along the iliac surface on AP view of the pelvis (solid arrows). Soft tissue calcifications adjacent to right greater trochanter (dashed arrows), vascular calcification adjacent to the left femoral head (double dashed arrows), and a right femoral dialysis catheter.

Wikipedia • CC BY 3.0

Renal

osteodystrophy • Renal osteodystrophy - hand - Ganzer Fall bei Radiopaedia

Salam, H. Renal osteodystrophy - hand. Case study, Radiopaedia.org. (accessed on 06 Nov 2022) https://doi.org/10.53347/rID-7897 • CC by-nc-sa 3.0 (modified)

Brown tumor

• Brown tumor - Ganzer Fall bei Radiopaedia

Anan R, Brown tumor. Case study, Radiopaedia.org (Accessed on 02 Dec 2023) https://doi.org/10.53347/rID-171650 • CC by-nc-sa 3.0 (modified)

Brown tumor

• Renal osteodystrophy - Ganzer Fall bei Radiopaedia

Ibrahim, D. Renal osteodystrophy. Case study, Radiopaedia.org. (accessed on 23 Oct 2022) https://doi.org/10.53347/rID-58863 • CC by-nc-sa 3.0 (modified)

Rugger jersey

spine (hyperparathyroidism) • Renal osteodystrophy - Ganzer Fall bei Radiopaedia

Shah, V. Renal osteodystrophy. Case study, Radiopaedia.org. (accessed on 02 Nov 2022) https://doi.org/10.53347/rID-57722 • CC by-nc-sa 3.0 (modified)

Rugger jersey

spine (hyperparathyroidism) • Renal osteodystrophy - Ganzer Fall bei Radiopaedia

Abdrabou, A. Renal osteodystrophy. Case study, Radiopaedia.org. (accessed on 02 Nov 2022) https://doi.org/10.53347/rID-35418 • CC by-nc-sa 3.0 (modified)

Salt and

pepper sign (skull) • Renal osteodystrophy of the skull vault - Ganzer Fall bei Radiopaedia

O'Donnell, C. Renal osteodystrophy of the skull vault. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-30704 • CC by-nc-sa 3.0 (modified)

Brown tumor

• Brown tumors compressing the spinal cord - Ganzer Fall bei Radiopaedia

Glick, Y. Brown tumors compressing the spinal cord. Case study, Radiopaedia.org. (accessed on 23 Oct 2022) https://doi.org/10.53347/rID-68442 • CC by-nc-sa 3.0 (modified)

Hyperparathyroidism

• Rugger-jersey spine - Ganzer Fall bei Radiopaedia

Dawes, L. Rugger-jersey spine. Case study, Radiopaedia.org. (accessed on 23 Oct 2022) https://doi.org/10.53347/rID-35892 • CC by-nc-sa 3.0 (modified)

The clothes

maketh the sign. Bone scintigram in a 25-year-old man with renal failure and arthralgia. A frontal planar image (a) and magnified view (b) demonstrates expansion of the manubrium and sternum without manubriosternal joint expansion resulting in a necktie appearance. In addition, a prominent calvarium and faint visualization of the kidneys are also supportive of a diagnosis of renal osteodystrophy

insightsimaging.springeropen.com • Open Access

Radiological

review of skull lesions. Renal osteodystrophy and osteopenia. Patient 1: Axial (a) and coronal (b) head CT images depict granular de-ossification with a “pepper pot” appearance (thick arrows) and loss of distinction of the inner and outer tables (dashed arrows) in this patient with renal osteodystrophy. Patient 2: Axial (c) and coronal (d) head CT images show demineralisation of the skull (arrowheads) in this patient with osteopenia. Note the relative preservation of the distinction of the inner and outer tables in osteopenia

insightsimaging.springeropen.com • Open Access

Radiopaedia • CC-by-nc-sa 3.0 • de

Renal osteodystrophy (ROD), also known as uremic osteopathy, is a constellation of musculoskeletal abnormalities that occur in patients with chronic renal failure, due to concurrent and superimposed:

osteomalacia (adults)/rickets (children)
secondary hyperparathyroidism: abnormal calcium and phosphate metabolism
- bone resorption
- osteosclerosis
- soft tissue and vascular calcifications
- brown tumors
aluminum intoxication, e.g. if the patient is on dialysis

Radiographic features

Imaging findings are many and varied:

osteopenia: (often seen early) thinning of cortices and trabeculae
salt and pepper skull
demineralization: usually subperiosteal, however, it may also involve joint margins, endosteal, subchondral, subligamentous areas, cortical bone, or trabeculae
subperiosteal resorption: characteristic subperiosteal resorption may be seen on radial aspects of middle phalanges of index and long fingers
bone sclerosis
- diffuse bony sclerosis
- rugger jersey spine: sclerosis of the vertebral body endplates
soft tissue calcification
amyloid deposition: erosion in and around joint
insufficiency fractures
Looser zone
brown tumors