Tibial insufficiency fractures in adult renal transplant recipients

Osteonecrosis and osteopenia are widely recognized skeletal complications of therapy in recipients of renal transplants. These conditions are often complicated by fractures, usually in the femora, pelvis or vertebrae. The authors describe two sedentary adult allograft recipients who presented with leg pain and in whom bone scintigraphy, serial radiographs, and clinical progress were suggestive of insufficiency fractures of the tibiae. Although seldom reported, insufficiency fractures should be considered in the differential diagnosis of renal allograft recipients with leg pain.