Painful bone end sclerosis. Variant of renal osteodystrophy simulating osteonecrosis

Painless sclerotic change in bone ends occurring as a manifestation of renal osteodystrophy has been reported in two previous cases. The sclerotic change can, however, be accompanied by nonspecific periarticular pain. Radiologic changes in "bone ends" may mimic osteonecrosis. Nuclear bone scanning may show increased radionuclide uptake early in both conditions but late uptake may be less in "bone end sclerosis." The "rugger jersey" spine occurring in the usual osteosclerosis of renal osteodystrophy has been consistently absent in this variant. Osteonecrosis should be excluded in making the diagnosis of "bone end sclerosis."