Abstract:

This paper reports one case of a 46-year-old male patient with a 6-year history of stage 5 chronic kidney disease who had been undergoing long-term peritoneal dialysis and was admitted for generalized pain and limited movement following a minor fall. Laboratory examinations revealed severe hyperphosphatemia (2.85 mmol/L), hypocalcemia (2.04 mmol/L), and markedly elevated parathyroid hormone levels (356 pg/mL). Whole-body bone scintigraphy combined with single-photon emission computed tomography (SPECT)/CT showed extensive abnormal radiotracer accumulation in the soft tissues around the bilateral shoulder joints, hip joints, and pubic symphysis, which precisely matched the calcified masses shown on CT. Typical signs of metabolic bone disease and multiple acute fractures corresponding to traumatic injury sites were also detected. The patient was finally diagnosed with renal osteodystrophy accompanied by extensive metastatic calcification. This case suggests that whole-body bone scintigraphy combined with SPECT/CT is of great value in the comprehensive evaluation of patients with chronic kidney disease. As a one-stop imaging examination, it can simultaneously detect soft tissue calcification, evaluate the type and severity of metabolic bone disease, identify occult fractures, and provide comprehensive evidence for clinical diagnosis and treatment.

Key words: metastatic calcification, renal osteodystrophy, secondary hyperparathyroidism, bone scintigraphy