ORTHOPAEDICS

Case 1 :

A 23 year old male presented with left sided jaw swelling of 15 days duration. CT scan of the jaw and para nasal sinuses was performed.
On viewing the CT pictures, the radiologist has asked for a skeletal survey.
Picture 2 is a radiograph of the lumbar spine.
What is your diagnosis ?
Which other test would you do to confirm it ?

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Diagnosis : Renal osteodystrophy

A sonography of the abdomen in this patient revealed bilaterally scarred, contracted kidneys with loss of cortico medullary differentiation.
Renal osteodystrophy is almost always due to renal glomerular disease either bilateral chronic pyelonephritis or glomerulonephritis.
Radiographic features in this condition include rugger jersey spine as seen in this patient, soft tissue calcification, rickets / osteomalacia, secondary hyperparathyroidism (subperiosteal erosions, brown tumours as noted here, though commonly seen in primary rather than secondary hyperparathyroidism), and delayed skeletal maturation.

Contribution : Dr Bhujang Pai, Dr Chris de Souza.