Sundaram M, Phillipp S R, Wolverson M K, Riaz M A, Rao B J
Skeletal Radiol. 1980;5(4):247-9. doi: 10.1007/BF00580598.
A recent publication showed the earliest signs of renal osteodystrophy in patients on maintenance hemodialysis (MHD) to occur in the tufts [1]. We present three patients on MHD, in two of whom the earliest unequivocal radiographic improvement was seen in the tufts. The third patient had been on MHD and, following subtotal parathyroidectomy, showed significant osseous improvement in the hands with relatively equal improvement in the hands with relatively equal improvement in the tufts and middle phalanges. It appears that, with the use of routine primary or secondary magnification, the tufts are radiographically a highly sensitive site for both the early occurrence and improvement of osteodystrophy in patients on MHD. We are not aware of any previous publication pointing out exclusive improvement in the tufts in patients on MHD with virtually no change in the mid-phalanges. Two of these three cases illustrate that renal osteodystrophy is reversible by maintenance hemodialysis alone.
最近的一项研究表明，维持性血液透析（MHD）患者肾性骨营养不良最早的迹象出现在指端[1]。我们报告了3例MHD患者，其中2例最早明确的影像学改善出现在指端。第3例患者接受MHD治疗，在次全甲状旁腺切除术后，手部出现明显的骨质改善，指端和中节指骨的改善程度相对相同。似乎，通过常规的一次或二次放大，指端在影像学上是MHD患者骨营养不良早期发生和改善的高度敏感部位。我们不知道之前有任何出版物指出MHD患者指端有排他性改善而中节指骨几乎没有变化。这3例中的2例表明，仅通过维持性血液透析，肾性骨营养不良是可逆的。
