The patient is a 68-year-old man with end-stage renal disease, in whom kidney transplantation had been unsuccessful. He had been receiving hemodialysis for 20 years. He had had a carpal tunnel release and now presents with increasing pain and swelling in the shoulders, wrists, knees, and hips.Well-defined erosion of the femoral neck with preservation of the femoral head suggests the presence Radiologic findingsAn anteroposterior view of the pelvis (Figure 1) shows multiple surgical clips, generalized osteopenia, and vascular calcifications. These findings are consistent with the patient's history of chronic renal failure and transplantation. In addition, there are prominent erosions of the femoral necks bilaterally, with good preservation of the hip cartilage. A well-defined left acetabular lucent lesion is present (Figure 2).
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