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Bilateral Olecranon and Left Lesser Trochanter Avulsion Fractures in Renal Osteodystrophy: A Rare Case Report and Comprehensive Review

  • Vijay Ram Kumar Papineni
  • , Shashank Chapala
  • , Rajesh Botchu
  • , Asad Rabbani Shah
  • , Kartikeyan P. Iyengar
  • , Balamurugan Rathinavelu
  • Asian Institute of Gastroenterology India
  • Royal National Orthopaedic Hospital NHS Trust
  • Sheikh Shakhbout Medical City
  • Southport and Ormskirk Hospital NHS Trust

Research output: Contribution to journalArticlepeer-review

Abstract

Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) disrupts phosphorus and calcium metabolism, leading to skeletal disorders such as demineralization, weakened bones, and an increased fracture risk. These disorders, known as renal osteodystrophy, vary widely and are classified into secondary hyperparathyroidism, adynamic bone, and osteomalacia based on bone turnover. Fracture risk increases with the severity of CKD, particularly in advanced stages (creatinine clearance <15–20 mL/min), but even patients with mild to moderate CKD are at risk of fractures. Fractures of the Lesser Trochanter (LT) in adults are rare, and most are caused by underlying malignancies. We present a case of simultaneous avulsion fractures in the left lesser trochanter and bilateral olecranon processes secondary to minor trauma in a young patient with End Stage Renal Disease, which has not been previously reported, and review the literature. This review summarizes the role of imaging (Radiography, US, Computed Tomography, and Magnetic Resonance Imaging) in assessing avulsion fractures in patients with end-stage renal disease. Ultrasound serves as a supportive tool in evaluating the neuromusculoskeletal system; however, in patients with end-stage renal disease, radiography, CT, and MRI remain the primary imaging modalities for assessing avulsion fractures.

Original languageEnglish
Pages (from-to)266-274
Number of pages9
JournalActa Medica Lituanica
Volume32
Issue number2
DOIs
StatePublished - 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • Chronic Kidney Disease-Mineral and Bone Disorder
  • Magnetic Resonance Imaging
  • avulsion fractures
  • femur
  • olecranon process
  • radiography
  • ultrasonography

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