{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T02:54:36Z","timestamp":1764989676759,"version":"3.46.0"},"reference-count":14,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1983,3]]},"abstract":"<jats:p>A patient with chronic renal failure, a dialysis encephalopathy syndrome and renal osteodystrophy associated with aluminium intoxication developed an avascular necrosis of the left femoral head. Histological examination of the excised head confirmed the zone of avascular necrosis and demonstrated an exuberant formation of cartilage around this zone. Calcification was sparse and the cartilage exhibited histological features similar to those seen in classical rickets. Histochemical and electron probe x-ray microanalysis demonstrated aluminium in the matrix around hypertrophic chondrocytes, at the tide mark of articular cartilage and at the mineralised tissue\/osteoid interface of trabecular bone. Aluminium, therefore, preferentially localises at sites of calcification and possibly exerts an inhibitory effect on this reaction. This is taken to account for the relative failure of endochrondral ossification and the development of a rachitic appearance. A comparison with five other examples of avascular necrosis of the femoral head (occurring after renal transplantation, as an idiopathic phenomenon and as a complication of steroid therapy) showed that, in addition to the more commonly described appositional bone formation, cartilage formation and endochondral ossification were present in three of these comparison cases, although less prominent and of considerably less degree than in the main case.<\/jats:p>","DOI":"10.1136\/jcp.36.3.260","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"260-268","source":"Crossref","is-referenced-by-count":5,"title":["Consequences of avascular necrosis of the femoral head in aluminium-related renal osteodystrophy and the role of endochondral ossification in the repair process."],"prefix":"10.1136","volume":"36","author":[{"given":"J","family":"McClure","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P S","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1983,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1136\/jcp.34.11.1285","article-title":"Dialysis encephalopathy, bone disease and anaemia: the aluminium intoxication syndrome during regular haemodialysis","volume":"34","author":"Parkinson, I.S.; Ward, M.K.; Kerr, D.N.S.","year":"1981","unstructured":"Parkinson IS, Ward MK, Kerr DNS. Dialysis encephalopathy, bone disease and anaemia: the aluminium intoxication syndrome during regular haemodialysis. J Clin Pathol 1981;34:1285-94.","journal-title":"J Clin Pathol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1136\/jcp.35.11.1283","article-title":"Localisation of aluminium by histochemical and electron probe x-ray microanalytical techniques in bone tissue of cases of renal osteodystrophy","volume":"35","author":"Smith, P.S.; McClure, J.","year":"1982","unstructured":"Smith PS, McClure J. Localisation of aluminium by histochemical and electron probe x-ray microanalytical techniques in bone tissue of cases of renal osteodystrophy. J Clin Pathol 1982;35: 1283-93.","journal-title":"J Clin Pathol"},{"key":"ref_3","first-page":"218","article-title":"The demonstration of aluminium in animal tissues","volume":"12","author":"Irwin, D.A.","year":"1955","unstructured":"Irwin DA. The demonstration of aluminium in animal tissues. 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Late function and complications","volume":"61","author":"Starzl, T.E.; Marchioro, T.L.; Porter, K.A.; Moore, C.A.; Rifkind, D.; Waddell, W.R.","year":"1964","unstructured":"Starzl TE, Marchioro TL, Porter KA, Moore CA, Rifkind D, Waddell WR. Renal homotransplantation. Late function and complications. Ann Intern Med 1964;61:470-97.","journal-title":"Ann Intern Med"},{"key":"ref_7","first-page":"25","article-title":"Aseptic necrosis of bone following renal transplantation. Experience in","volume":"57","author":"Ibels, L.S.; Alfrey, A.C.; Huffer, W.E.; Weil, R.","year":"1978","unstructured":"Ibels LS, Alfrey AC, Huffer WE, Weil R. Aseptic necrosis of bone following renal transplantation. Experience in 194 transplant recipients and review of the literature. 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Haemodialysis-related osteomalacia: a staining method to demonstrate aluminium. J Clin Pathol 1981;34:1352-4.","journal-title":"J Clin Pathol"},{"key":"ref_10","article-title":"Metabolic, degenerative and inflammatory diseases of bones and joints. Philadelphia: Lea and Febiger","author":"Jaffe, H.L.","year":"1972","unstructured":"Jaffe HL. Metabolic, degenerative and inflammatory diseases of bones and joints. Philadelphia: Lea and Febiger, 1972."},{"key":"ref_11","first-page":"74976","article-title":"A histological study of avascular necrosis of the femoral head after transcervical fracture","volume":"45","author":"Catto, M.","year":"1965","unstructured":"Catto M. A histological study of avascular necrosis of the femoral head after transcervical fracture. J Bone Jt Surg 1965;45-B:74976.","journal-title":"J Bone Jt Surg"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1302\/0301-620X.47B4.777","article-title":"The histological appearances of late segmental collapse of the femoral head after transcervical fracture","volume":"47","author":"Catto, M.","year":"1965","unstructured":"Catto M. The histological appearances of late segmental collapse of the femoral head after transcervical fracture. J Bone Jt Surg 1965;47-B:777-91.","journal-title":"J Bone Jt Surg"},{"key":"ref_13","first-page":"283","article-title":"The biology of osteonecrosis of the human femoral head and its clinical implications: II The pathological changes in the femoral head as an organ and in the hip joint","volume":"139","author":"Glimcher, M.J.; Kenzora, J.E.","year":"1979","unstructured":"Glimcher MJ, Kenzora JE. 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