PMID: 6402524Mar 1, 1983Paper

Consequences of avascular necrosis of the femoral head in aluminium-related renal osteodystrophy and the role of endochondral ossification in the repair process

Journal of Clinical Pathology
J McClure, P S Smith

Abstract

A patient with chronic renal failure, a dialysis encephalopathy syndrome and renal osteodystrophy associated with aluminium intoxication developed an avascular necrosis of the left femoral head. Histological examination of the excised head confirmed the zone of avascular necrosis and demonstrated an exuberant formation of cartilage around this zone. Calcification was sparse and the cartilage exhibited histological features similar to those seen in classical rickets. Histochemical and electron probe x-ray microanalysis demonstrated aluminium in the matrix around hypertrophic chondrocytes, at the tide mark of articular cartilage and at the mineralised tissue/osteoid interface of trabecular bone. Aluminium, therefore, preferentially localises at sites of calcification and possibly exerts an inhibitory effect on this reaction. This is taken to account for the relative failure of endochrondral ossification and the development of a rachitic appearance. A comparison with five other examples of avascular necrosis of the femoral head (occurring after renal transplantation, as an idiopathic phenomenon and as a complication of steroid therapy) showed that, in addition to the more commonly described appositional bone formation, cartilage f...Continue Reading

References

Mar 1, 1972·Journal of Clinical Pathology·V Raina
Dec 1, 1981·Journal of Clinical Pathology·M R BuchananC M Dunn
Sep 1, 1964·Annals of Internal Medicine·T E STARZLW R WADDELL

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