Bone Pathology Database

Teaching Version

Text in Italics is general (instructional) information

Lateral X ray

After intramedullary fixation

The MR view on the previous page shows the subtrochanteric femur fracture embedded in the mass of calcified material. The AP and lateral views show the femur head and little detail of the fracture itself. There is a large mass of calcified material about the proximal femur it is organised into well rounded lobules and does not suggest a malignant cause. There was a similar mass in the other thigh as well as both forearms. The fracture was stabilised by intramedullary fixation. Histology of the mass showed calsification of muscle.

The pathological fracture was caused by decalcification of the femur due to hyperparathyroidism. The calcium is deposited in the soft tissues as renal failure later causes a raise in phosphate levels. This is due to failure of the distal tubules to re-secrete phosphate -( this develops in late stage chronic renal failure.)
Once calcium and phosphate levels rise, the material accumulates in the tissues as the large masses seen. Surgical excision is not possible at this advanced stage and control of this ectopic calcium must be by renal dialysis.

Record

108