Scanning electron microscopy and x-ray diffraction studies of human bone oxalosis.

Postmortem scanning electron microscopy of human phalanges in a chronic uremic hemodialysis patient with hyperparathyroidism showed the presence of confluence abnormal rounded formations with a radial rosette-like crystalline pattern in the diaphysis as well as in the epiphyseal part of the bones. These fan-shaped configurations were found either as individual formations within bone trabeculae or as numerous aggregated crystalline deposits replacing large parts of the bone structure. The microdissected content of such large areas submitted to X-ray diffraction analysis revealed the predominant presence of calcium oxalate monohydrate or whewellite with some traces of hydroxyapatite. Oxalate titration analysis indicated the presence of 25% of oxalate, corresponding to 45% in weight of whewellite.