Presentation
Preoperative radiograph for kidney transplant
Patient Data
A peritoneal dialysis catheter overlies the lower pelvis satisfactorily. Multiple radiopaque densities scattered throughout the colon, likely PICA and geophagia. These have increased in the one year interval between radiographs.
Splenic calcified granulomas.
The right femur demonstrates post-surgical changes from previous core decompression of avascular necrosis of the right femoral head by a vascularized fibular graft. AVN both femoral heads.
IMPRESSION:
Correlate with patient's history regarding Pica, and geophagia. Differential diagnosis: Lanthanum therapy.
Case Discussion
Chart review confirms the patient was on Lanthanum for hyperphosphatemia.
What are the atomic numbers for Barium and Lanthanum? This is why Lanthanum has a similar radiographic density as Barium.
This case highlights the importance of medication history in interpretation of abdominal radiographs.
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