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Radiology, Vol 156, 663-667, Copyright © 1985 by Radiological Society of North America

ARTICLES

Aluminum bone disease in children: radiographic features from diagnosis to resolution

SP Andreoli, JA Smith and JM Bergstein

Two children with chronic renal failure developed aluminum intoxication as a result of long-term ingestion of aluminum hydroxide for the control of hyperphosphatemia. In each child, bone biopsy confirmed severe osteomalacia, the absence of features of hyperparathyroid bone disease, and massive aluminum deposition at the bone-osteoid junction. Radiographs during the period of aluminum intoxication demonstrated osteopenia, pathologic fractures, fraying of the metaphyses of the long bones, and widening of the physis. When aluminum hydroxide therapy was discontinued (each patient) and aluminum was removed with chelation therapy (one patient), radiographs demonstrated a distinctly unusual pattern of healing. Calcification of the long bones began at the most recently formed osteoid and then proceeded toward the diaphysis. This unusual healing pattern created lucent defects and a transient "bone within a bone" appearance, which resolved with further healing.


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E. K. Pivnick, N. C. Kerr, R. A. Kaufman, D. P. Jones, and R. W. Chesney
Rickets Secondary to Phosphate Depletion: A Sequela of Antacid Use in Infancy
Clinical Pediatrics, February 1, 1995; 34(2): 73 - 78.
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