When Crystals Break Bones: A Case Report of Femoral Fracture Revealing Silent Bone Oxalosis

Secondary oxalosis results from systemic oxalate accumulation most frequently associated with advanced renal failure and long-term hemodialysis. Although deposition most commonly affects the kidney, bone involvement may lead to skeletal fragility, pain, and pathological fractures. Bone oxalosis represents a rare but clinically significant complication of systemic oxalosis. We report the case of a 64-year-old woman undergoing long-term hemodialysis who presented with a pathological femoral neck fracture. Radiological assessment and histopathological analysis were consistent with bone oxalosis secondary to chronic kidney failure. This case underscores the diagnostic challenge posed by bone oxalosis, which often presents with nonspecific skeletal manifestations. Although infrequently reported, bone oxalosis should be considered in the differential diagnosis of unexplained skeletal pathology in dialysis patients. An early recognition and a multidisciplinary approach integrating clinical, radiological, and histopathological assessment is critical for accurate diagnosis and effective management.