Measurement of periosteal resorption (PR) at the radial and ulnar surfaces of the second, third and fourth middle phalanges of one hand in 60 normals and 61 chronic renal failure (CRF) patients showed generally higher involvement at the radial than the ulnar surfaces; however, best diagnostic results were achieved when PR was measured at both radial and ulnar surfaces of the index finger only. With the quantitative method, 31 of 61 CRF patients showed changes, whereas only 22 were identified with the grading method.