1/7. Bilateral slipped upper femoral epiphysis: a rare manifestation of renal osteodystrophy. Case report with discussion of its pathogenesis.Bilateral slipped upper femoral epiphysis is a rare manifestation of renal osteodystrophy. A case of bilateral slipped femoral epiphysis in an 18-year old male suffering from chronic renal failure due to oligomeganephronic renal hypoplasia with profound signs of renal osteodystrophy is presented. serum growth hormone levels were high, while those of urinary 17-ketosteroids were decreased. Following subtotal parathyroidectomy, the progression of the process leading to slipped epiphysis was halted with closure of the epiphyses. The patient was subsequently treated with chronic hemodialysis for several months, after which successful renal transplantation was performed. The pathogenesis of renal osteodystrophy leading to slipped epiphysis is discussed and attention drawn to the fact that bilateral slipped femoral epiphysis may be the first clinical sign of chronic renal insufficiency.- - - - - - - - - - ranking = 1keywords = epiphysis (Clic here for more details about this article) |
2/7. Prominent Tc-99m MIBI skeletal uptake in renal osteodystrophy: a possible role for whole-body scanning.renal osteodystrophy is a process whereby renal failure causes profound bone disease. Effects on bone include osteosclerosis, osteomalacia, osteoporosis, pathologic fractures, aseptic necrosis of the hips, and bone pain. The authors present a case of renal osteodystrophy with intense Tc-99m 2-methoxy isobutyl isonitrile (MIBI) radiotracer uptake in the mandible and propose that Tc-99m MIBI may have a potential role in diagnosing renal osteodystrophy.- - - - - - - - - - ranking = 1.3206407981736E-5keywords = body (Clic here for more details about this article) |
3/7. Treatment of slipped capital femoral epiphysis resulting from juvenile renal osteodystrophy.Severe bilateral slipped capital femoral epiphysis (SCFE) secondary to renal osteodystrophy is infrequent at any age. Management was a significant dilemma in the 3-year-old child we report because of the degree of slippage and our concern over the sequelae of premature capital physeal closure. Fixation without physeal closure was obtained by inserting a specially fabricated screw without threads across the physis after the slippage had been reduced with traction.- - - - - - - - - - ranking = 0.55555555555556keywords = epiphysis (Clic here for more details about this article) |
4/7. slipped capital femoral epiphyses complicating renal osteodystrophy: a report of three cases.Three adolescents with bilateral slipped capital femoral epiphyses complicating renal disease are presented. In one case, the severity of the deformities necessitated total hip replacement. Pathological specimens were available for evaluation. In all 3 cases, epiphysiolysis was accompanied by severe subperiosteal reabsorption along the medial aspect of the femoral neck, widening of the cartilaginous growth plate, and coxa vara. The radiographic diagnosis of a minimally displaced femoral epiphysis may precede the clinical symptoms. Early recognition of this complication is important, since the treatment of choice is prophylactic surgical stabilization before disabling deformities occur.- - - - - - - - - - ranking = 0.11111111111111keywords = epiphysis (Clic here for more details about this article) |
5/7. Total parathyroidectomy and autotransplantation for tertiary hyperparathyroidism in children with chronic renal failure.An association between chronic renal failure and skeletal deformities in the adolescent patient was first documented by Lucas in 1883. Since then it has been established that the kidneys play a major role in the regulation of calcium, phosphate, and parathyroid hormone, and that chronic renal failure is characterized by profound alterations in the normal metabolic homeostasis of the human body. With the hyperphosphatemia of uremia, compensatory hyperparathyroidism is also a well known complication. Due to these factors, loss of normal renal function ultimately leads to derangement in mineral and bone metabolism resulting in severe skeletal deformities. Reports in the English literature suggest that the changes of renal osteodystrophy are much more pronounced in the pediatric patient, as compared to those in the adult. In the last two decades, renal transplantation has come to be recognized as a satisfactory modality for controlling renal failure and its complications. This procedure is often not available as an option, however, in small patients, especially those under three years of age. The pediatric nephrologist is often forced to manage these patients for long periods with conservative therapy, in an attempt to control the ravages of renal osteodystrophy. The problem becomes unmanageable when the compensatory hyperparathyroidism proceeds to autonomy. When this occurs, despite maintenance of normal serum calcium levels, the renal osteodystrophy progresses rapidly, producing pain, deformities and growth retardation. At this point, the condition is often refractory to medical management and resection of parathyroid tissue remains the only satisfactory modality for control.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 3.3016019954341E-6keywords = body (Clic here for more details about this article) |
6/7. Slippage of the distal tibial epiphysis.Three cases of valgus slippage of the distal tibial and fibular epiphysis that masqueraded as severe idiopathic flatfoot are described. These occurred in patients with renal osteodystrophy and were treated by osteotomies of the reverse dome type without internal fixation. All the osteotomies healed well.- - - - - - - - - - ranking = 0.55555555555556keywords = epiphysis (Clic here for more details about this article) |
7/7. Bilateral slipping of the upper femoral epiphysis in end-stage renal failure. A report of two cases.Two cases of bilateral slipping of the upper femoral epiphysis in boys with end-stage renal failure due to megacystis and mega-ureter with severe renal osteodystrophy are reported. In one patient the lesion emerged after a dystonic reaction to drugs and in the other after bilateral nephro-ureterectomy. Neither showed marked elevation of growth hormone levels, but both had evidence of renal rickets with severe secondary hyperparathyroidism. Both had a satisfactory response to bilateral internal fixation. The complication should be borne in mind in all young patients with renal osteodystrophy.- - - - - - - - - - ranking = 0.55555555555556keywords = epiphysis (Clic here for more details about this article) |