Comparison of mammographic and industrial films in dialysis patients

PURPOSE: To optimize the technique for radiographic studies of bone and joint damage in renal osteodystrophy. MATERIAL AND METHODS: Sixty-four patients with chronic renal failure on dialysis for 0-10 years, were divided into two homogeneous groups and submitted to two different radiographic examinations of the nondominant hand. Group A patients were examined with a conventional radiological unit and an industrial film and a conventional radiological unit with a mammographic film with a dedicated screen, while group B patients with a mammographic with an industrial film and a conventional radiologic unit with a mammographic film with a dedicated screen. The examinations were evaluated by three radiologists in a double-blind fashion. RESULTS: Bone conditions such as osteoporomalacia, trabecular rarefaction, channel enlargement and intracortical absorption were equally demonstrated by mammographic films and the mammograph with industrial films. The mammographic film was superior to the mammograph with an industrial film in 8 cases, comparable in 25 and inferior in 6, but when compared with the conventional radiological unit with an industrial film it was superior in 19 cases, comparable in 2 and never inferior. CONCLUSIONS: The industrial film without a screen combined with a mammograph is considered the gold standard to study fine bone alterations in renal osteodystrophy. However the conventional radiological unit with a mammographic film with a dedicated screen provides the same results with lower irradiation doses and can therefore be considered a good alternative.