The different radiographical abnormalities of the hand with renal osteodystrophy are demonstrated. The soft tissue immersion low-energy X-ray technique allows early detection of macrostructural changes of spongy and compact bone, irregularities of the cortex, defects and pseudocysts, osteosclerosis as well as calcifications in the soft tissue and arterio sclerosis of patients with chronic renal failure. Possible erroneous interpretations will be discussed.

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