Periosteal new bone formation in chronic renal failure

A retrospective analysis of the skeletal surveys of 47 patients with periosteal new bone formation (PNB) associated with chronic renal failure was performed in order to determine the radiological features of this abnormality. Sequential skeletal surveys identified the time of development of PNB in 11 patients. The aetiology of PNB was investigated by reviewing biochemical and pathological data for these patients during this period. Symmetrical involvement of weight bearing bones was a typical feature of PNB. PNB was often identified at multiple sites. No association of PNB with radiological, biochemical or pathological evidence of aluminium induced osteomalacia was found. Both hyperparathyroidism and osteosclerosis were common in patients with PNB but since hyperparathyroidism is a frequent occurrence in patients with chronic renal failure its relationship to PNB is not necessarily causal.