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Renal Osteodystrophy
Kirkland W. Davis, MD, FACR; Cheryl A. Petersilge, MD, MBA
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          TERMINOLOGY

          • Definitions

            • Renal osteodystrophy (ROD): musculoskeletal manifestations of osteomalacia and 2° hyperparathyroidism (HPTH)
              • 2° HPTH includes bone resorption, osteoporosis, soft tissue calcifications, bone deposition
              • Complications of dialysis often lumped into ROD: amyloidosis and destructive spondyloarthropathy
            • Chronic kidney disease-mineral bone disorder (CKD-MBD): newer term for syndrome of abnormalities of calcium, phosphorus, vitamin D, and parathyroid hormone (PTH) with associated bone changes and extraskeletal calcification caused by CKD
            • Neostosis: anachronistic term for bone production/deposition; not favored

          IMAGING

          • General Features

            • Imaging Recommendations

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Other Modality Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Microscopic Features

                              • Laboratory Analysis

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    Selected References

                                    1. Gulati V et al: Sclerotic bone lesions caused by non-infectious and non-neoplastic diseases: a review of the imaging and clinicopathologic findings. Skeletal Radiol. 50(5):847-69, 2021
                                    2. Testini V et al: Metabolic bone diseases in the pediatric population. Semin Musculoskelet Radiol. 25(1):94-104, 2021
                                    3. Usmani S et al: Update on imaging in chronic kidney disease-mineral and bone disorder: promising role of functional imaging. Skeletal Radiol. ePub, 2021
                                    4. Alexander AJ et al: Imaging in chronic kidney disease-metabolic bone disease. Semin Dial. 30(4):361-8, 2017
                                    5. Babayev R et al: Bone disorders in chronic kidney disease: an update in diagnosis and management. Semin Dial. 28(6):645-53, 2015
                                    6. Degrassi F et al: Imaging of haemodialysis: renal and extrarenal findings. Insights Imaging. 6(3):309-21, 2015
                                    7. Kazama JJ et al: Chronic kidney disease and bone metabolism. J Bone Miner Metab. 33(3):245-52, 2015
                                    8. Abdel Razek AA: Computed tomography and magnetic resonance imaging of maxillofacial lesions in renal osteodystrophy. J Craniofac Surg. 25(4):1354-7, 2014
                                    9. Rajapakse CS et al: Micro-MR imaging-based computational biomechanics demonstrates reduction in cortical and trabecular bone strength after renal transplantation. Radiology. 262(3):912-20, 2012
                                    10. Sundaram M. Founders lecture 2007: Metabolic bone disease: what has changed in 30 years? Skeletal Radiol. 38(9):841-53, 2009
                                    11. Kelly A et al: Musculoskeletal pain in dialysis-related amyloidosis. Can J Surg. 50(4):305-6, 2007
                                    12. Slavotinek JP et al: Shoulder appearances at MR imaging in long-term dialysis recipients. Radiology. 217(2):539-43, 2000
                                    13. Murphey MD et al: Musculoskeletal manifestations of chronic renal insufficiency. Radiographics. 13(2):357-79, 1993
                                    14. Kurer MH et al: Musculoskeletal manifestations of amyloidosis. A review of 83 patients on haemodialysis for at least 10 years. J Bone Joint Surg Br. 73(2):271-6, 1991
                                    15. Jensen PS et al: Early radiographic manifestations of secondary hyperparathyroidism associated with chronic renal disease. Radiology. 125(3):645-52, 1977
                                    16. Greenfield GB: Roentgen appearance of bone and soft tissue changes in chronic renal disease. Am J Roentgenol Radium Ther Nucl Med. 116(4):749-57, 1972
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            TERMINOLOGY

                                            • Definitions

                                              • Renal osteodystrophy (ROD): musculoskeletal manifestations of osteomalacia and 2° hyperparathyroidism (HPTH)
                                                • 2° HPTH includes bone resorption, osteoporosis, soft tissue calcifications, bone deposition
                                                • Complications of dialysis often lumped into ROD: amyloidosis and destructive spondyloarthropathy
                                              • Chronic kidney disease-mineral bone disorder (CKD-MBD): newer term for syndrome of abnormalities of calcium, phosphorus, vitamin D, and parathyroid hormone (PTH) with associated bone changes and extraskeletal calcification caused by CKD
                                              • Neostosis: anachronistic term for bone production/deposition; not favored

                                            IMAGING

                                            • General Features

                                              • Imaging Recommendations

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Nuclear Medicine Findings

                                                        • Other Modality Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Microscopic Features

                                                                • Laboratory Analysis

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      Selected References

                                                                      1. Gulati V et al: Sclerotic bone lesions caused by non-infectious and non-neoplastic diseases: a review of the imaging and clinicopathologic findings. Skeletal Radiol. 50(5):847-69, 2021
                                                                      2. Testini V et al: Metabolic bone diseases in the pediatric population. Semin Musculoskelet Radiol. 25(1):94-104, 2021
                                                                      3. Usmani S et al: Update on imaging in chronic kidney disease-mineral and bone disorder: promising role of functional imaging. Skeletal Radiol. ePub, 2021
                                                                      4. Alexander AJ et al: Imaging in chronic kidney disease-metabolic bone disease. Semin Dial. 30(4):361-8, 2017
                                                                      5. Babayev R et al: Bone disorders in chronic kidney disease: an update in diagnosis and management. Semin Dial. 28(6):645-53, 2015
                                                                      6. Degrassi F et al: Imaging of haemodialysis: renal and extrarenal findings. Insights Imaging. 6(3):309-21, 2015
                                                                      7. Kazama JJ et al: Chronic kidney disease and bone metabolism. J Bone Miner Metab. 33(3):245-52, 2015
                                                                      8. Abdel Razek AA: Computed tomography and magnetic resonance imaging of maxillofacial lesions in renal osteodystrophy. J Craniofac Surg. 25(4):1354-7, 2014
                                                                      9. Rajapakse CS et al: Micro-MR imaging-based computational biomechanics demonstrates reduction in cortical and trabecular bone strength after renal transplantation. Radiology. 262(3):912-20, 2012
                                                                      10. Sundaram M. Founders lecture 2007: Metabolic bone disease: what has changed in 30 years? Skeletal Radiol. 38(9):841-53, 2009
                                                                      11. Kelly A et al: Musculoskeletal pain in dialysis-related amyloidosis. Can J Surg. 50(4):305-6, 2007
                                                                      12. Slavotinek JP et al: Shoulder appearances at MR imaging in long-term dialysis recipients. Radiology. 217(2):539-43, 2000
                                                                      13. Murphey MD et al: Musculoskeletal manifestations of chronic renal insufficiency. Radiographics. 13(2):357-79, 1993
                                                                      14. Kurer MH et al: Musculoskeletal manifestations of amyloidosis. A review of 83 patients on haemodialysis for at least 10 years. J Bone Joint Surg Br. 73(2):271-6, 1991
                                                                      15. Jensen PS et al: Early radiographic manifestations of secondary hyperparathyroidism associated with chronic renal disease. Radiology. 125(3):645-52, 1977
                                                                      16. Greenfield GB: Roentgen appearance of bone and soft tissue changes in chronic renal disease. Am J Roentgenol Radium Ther Nucl Med. 116(4):749-57, 1972