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3 Cards in this Set
- Front
- Back
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Hyperparathyroidism |
Radiographic features 1. subperiosteal bone resorption classically affects the radial aspects of the proximal and middle phalanges of the 2nd and 3rd fingers medial aspect of tibia, femur, humerus lamina dura: floating teeth (not specific) 2.subchondral resorption lateral end of the clavicles symphysis pubis sacroiliac joints 3.subligamentous resorption ischial tuberosity trochanters inferior surface of calcaneus and clavicle 4.intracortical resorption: cigar/oval-shaped or tunnel-shaped radiolucency in the cortex 5.terminal tuft erosion (acro-osteolysis) 6.rugger jersey spine 7.osteopenia 8.brown tumours 9.salt and pepper sign in the skull (pepper pot skull) 10.chondrocalcinosis |
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Secondary hyperparathyroidism |
Findings in secondary (and tertiary) hyperparathyroidism are often associated with the osteosclerosis of renal osteodystrophy and the osteomalacia of vitamin D deficiency:
subperiosteal bone resorption osteopenia osteosclerosis, e.g. rugger jersey spine soft tissue calcification superscan: generalised increased uptake on Tc-99m pertechnetate bone scan (focal uptake with adenoma) superior and inferior rib notching |
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Subtypes of Hyperparathyroidism |
primary hyperparathyroidism parathyroid adenoma (~80%) multiple parathyroid adenomas (4%) 5 parathyroid hyperplasia (10-15%) 2,5 parathyroid carcinoma (1-5%) 4,5 parathyromatosis (very rare) secondary hyperparathyroidism caused by chronic hypocalcaemia with renal osteodystrophy being the most common cause (others include malnutrition, vitamin D deficiency) 4 results in parathyroid hyperplasia 7 tertiary hyperparathyroidism autonomous parathyroid adenoma caused by the chronic overstimulation of hyperplastic glands in renal insufficiency |
