CASE 6
ANSWER: Nephrocalcinosis
of both kidneys caused by renal tubular acidosis.
She also had rickets.
.
The top part of the plain abdominal
film has wedge-shaped patches of calcifications
in both kidneys, which correspond
to the medullary pyramids.
..
In the bottom part of the plain
abdominal film there are rarefaction of provisional zones of calcification,
irregular fraying at the proximal
femoral metaphyses and acetabular roofs, widened physes at proximal
femurs; and rarefaction of
the margins of the proximal femoral epiphyses.
Longitudinal ultrasonograms
of the right and left kidneys show
increased echogenicity in the
medullary part of the kidneys.
..
The film of both knees shows rarefaction of the provisional
zones of calcification, irregularly frayed
and cupping metaphyses, deepened physes, rarefaction
of the margins of the epiphyses, and
diffuse rarefaction of the shafts with thinning of
the cortex and coarsened texture.
DISCUSSION
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