A 42-year-old man undergoing maintenance hemodialysis suffered an attack of acute pancreatitis. Convential treatment resulted in quick recovery. 10 days after its onset his hands and feet became swollen, hot, red and painful. Multiple intramedullary osteolytic lesions of the metatarsals, metacarpals and phalanges, with cortical destruction and a number of fractures were found. These lesions subsided over many weeks and did not recur. We believe that such acute osteolytic lesions following pancreatitis are not ‘renal osteodystrophy’ as such, but should be recognized as a possible complication in renal failure patie