课件：透析相关性骨关节病.pptVIP

* 1 Osseous resorption in the hand of a 13-year.old boy with CRI owing to prune-belly syndrome. Anteroposterior(AP) magnification radiograph (2 : 1 direct enlargement) shows subperiosteal resorption about the terminal tufts (white arrowheads) and radial aspects of the middle and proximal phalanges (long arrows). Endosteal (short arrows) and subchondral (black arrowheads) resorption are also present. 2 Subperiosteal resorption and osteomalacia in a 36-year-old man with CRI. (a) AP magnification radiograph (2: 1 direct enlargement) of the hand shows subperiosteal (solid arrows) and intracortical (white arrowheads) resorption involving phalanges and the terminal tufts of the index and long fingers. A bandlike radiolucent area is seen at the base of the terminal tuft (open arrow). Trabeculae are ill-defined due to osteomalacia (black arrowheads). (b) Two years after parathyroidectomy, subperiosteal resorption has resolved, with some residual sclerosis and brachydactyly (*). (c) AP conventional tomogram reveals a spontaneous incomplete pseudofracture of the femoral neck (arrows). Subbigamentous resorption (arrowheads) is seen at the rectus femoris attachment. 1, 左边一个图像为58岁CRI患者，可见股骨远端一些骨质破坏（棕色瘤），皮质内可见许多病变。 右边两幅图像为45岁女性CRI患者，可见掌骨、下颌骨骨质吸收，形成棕色瘤。 (a) Radiograph obtamed with hip abduction in a 52-year-old man with CRI and elevated calcium-phosphorus product of 80 mg/dL shows soft-tissue calcification (arrowheads). (b) CT scan of the pelvis shows fluid-fluid levels (arrows) within the periarticular calcification. . 骨密度减低,骨小梁模糊及骨骼变形,椎体呈鱼椎样改变,侧弯或后突畸形, 假骨折影, 骨盆入口呈鸡心状或三角形,重者可成三叶状改变 Osteomalacia in a 45-year-old woman with long-standing CRI. Radiograph of the pelvis shows healing fractures (Looser zones) in the pubic rami and right femoral neck (arrowheads) and arthrokatadysis(arrows). 一般血液透析只能清除小分子物质，而β2-微球蛋白分子量为11800，为小分子蛋白，血液透析不能有效清除β2-微球蛋白。 一般血液透析只能清除小分子物质，而β2-微球蛋白分子量为11800，为小分子蛋白，血液透析不能有效清除β2-微球蛋白。 一般血液透析只能清除小分子物质，而β2-微球蛋白分子量为11800，为小分子蛋白，血液透析不能有效清除β2-微球蛋白。 Figure 1. MR