1. Presented by Edward McCarthy, M.D. and prepared by Lynette S. Nichols, M.D.

A 10 year old boy with chronic renal disease had a history of pain in his fourth MP joint of his right hand for several months. A radiograph demonstrated a lytic lesion in the metaphyseal area of the proximal phalanx as well as a small lytic lesion in the metaphysis of the metacarpal.

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