Hyperparathyroidism x ray: Difference between revisions
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Finding in primary hyperparathyroidism includes:<ref name="pmid24614783">{{cite journal |vauthors=Lachungpa T, Sarawagi R, Chakkalakkoombil SV, Jayamohan AE |title=Imaging features of primary hyperparathyroidism |journal=BMJ Case Rep |volume=2014 |issue= |pages= |year=2014 |pmid=24614783 |pmc=3962932 |doi=10.1136/bcr-2013-203521 |url=}}</ref> | Finding in primary hyperparathyroidism includes:<ref name="pmid24614783">{{cite journal |vauthors=Lachungpa T, Sarawagi R, Chakkalakkoombil SV, Jayamohan AE |title=Imaging features of primary hyperparathyroidism |journal=BMJ Case Rep |volume=2014 |issue= |pages= |year=2014 |pmid=24614783 |pmc=3962932 |doi=10.1136/bcr-2013-203521 |url=}}</ref> | ||
*Subperiosteal bone resorption | *Subperiosteal [[bone resorption]] | ||
**Classically affects the radial aspects of the proximal and middle phalanges of the | **Classically affects the radial aspects of the proximal and middle [[phalanges]] of the index and middle fingers | ||
**Medial aspect of tibia, femur, humerus | **Medial aspect of [[tibia]], [[femur]], [[humerus]] | ||
** | **Phalangeal tuft erosion (acro-osteolysis) | ||
**Lamina dura around teeth (floating teeth) | **Lamina dura around teeth (floating teeth) | ||
*Endoosteal bone resorption | *Endoosteal [[bone resorption]] | ||
**Widening of medullary cavity | **Widening of [[medullary cavity]] | ||
**Thinning of the inner cortex | **Thinning of the inner [[cortex]] | ||
*Subchondral resorption | *Subchondral [[resorption]] | ||
**Lateral end of the clavicles | **Lateral end of the [[Clavicle|clavicles]] | ||
**Symphysis pubis | **[[Pubic symphysis|Symphysis pubis]] | ||
**Sacroiliac joints | **[[Sacroiliac joint|Sacroiliac joints]] | ||
*Subligamentous resorption | *Subligamentous [[resorption]] | ||
**Ischial tuberosity | **[[Ischial tuberosity]] | ||
**Humeral tuberosity | **Humeral tuberosity | ||
**Trochanters | **[[Trochanters]] | ||
**Inferior surface of calcaneus | **Inferior surface of [[calcaneus]] | ||
**Inferior margin of lateral clavicle | **Inferior margin of lateral [[clavicle]] | ||
*Intracortical resorption: cigar/oval-shaped or tunnel-shaped radiolucency in the cortex | *Intracortical [[resorption]]: cigar/oval-shaped or tunnel-shaped radiolucency in the cortex | ||
* | *[[Osteopenia]] | ||
*Brown | *[[Brown tumor|Brown tumors]] | ||
*Salt and pepper sign in the skull (pepper pot skull) | *Salt and pepper sign in the skull (pepper pot skull) | ||
*Chondrocalcinosis | *[[Chondrocalcinosis]] | ||
===Secondary and tertiary hyperparathyroidism=== | ===Secondary and tertiary hyperparathyroidism=== | ||
X-ray is the preferred imaging for diagnosis of secondary hyperparathyroidism as majority of findings are radiological. <ref name="pmid7785573">{{cite journal |vauthors=Tigges S, Nance EP, Carpenter WA, Erb R |title=Renal osteodystrophy: imaging findings that mimic those of other diseases |journal=AJR Am J Roentgenol |volume=165 |issue=1 |pages=143–8 |year=1995 |pmid=7785573 |doi=10.2214/ajr.165.1.7785573 |url=http://www.ajronline.org/doi/pdf/10.2214/ajr.165.1.7785573}}</ref> | X-ray is the preferred imaging for diagnosis of secondary hyperparathyroidism as majority of findings are radiological. <ref name="pmid7785573">{{cite journal |vauthors=Tigges S, Nance EP, Carpenter WA, Erb R |title=Renal osteodystrophy: imaging findings that mimic those of other diseases |journal=AJR Am J Roentgenol |volume=165 |issue=1 |pages=143–8 |year=1995 |pmid=7785573 |doi=10.2214/ajr.165.1.7785573 |url=http://www.ajronline.org/doi/pdf/10.2214/ajr.165.1.7785573}}</ref> | ||
Findings in secondary and tertiary hyperparathyroidism are often associated with the osteosclerosis of renal osteodystrophy, and the osteomalacia of vitamin D deficiency: | 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 | *Subperiosteal [[bone resorption]] | ||
**Radial aspect of middle phalanges of index and long fingers are involved. | **Radial aspect of middle [[phalanges]] of index and long fingers are involved. | ||
*Subchondral resorption | *Subchondral resorption | ||
**Hands, hips, shoulders, patellofemoral and sacroiliac joints are involved. | **[[Hands]], [[hips]], [[shoulders]], patellofemoral and [[Sacroiliac joint|sacroiliac joints]] are involved. | ||
**Hands are involves in the ulnar side. | **Hands are involves in the [[ulnar]] side. | ||
**Distal interphalangeal and metacarpophalangeal joints are involved. | **Distal [[interphalangeal]] and [[metacarpophalangeal]] joints are involved. | ||
**Subchondral resorption is very severe. It may lead to bony collapse. | **Subchondral [[resorption]] is very severe. It may lead to bony collapse. | ||
*Subligamentous resorption | *Subligamentous resorption | ||
**Retrocalcaneal bursa and insertion of planter aponeurosis may be involved. | **Retrocalcaneal bursa and insertion of planter [[aponeurosis]] may be involved. | ||
*Severe osteopenia, may be complicated by pathologic fractures | *Severe [[osteopenia]], may be complicated by pathologic fractures | ||
*Osteosclerosis, e.g. rugger-jersey spine | *[[Osteosclerosis]], e.g. rugger-jersey spine | ||
*Brown tumor | *[[Brown tumor]] | ||
*Amyloid deposition | *[[Amyloid]] deposition | ||
**May be manifested as lytic bone lesion on radiograph | **May be manifested as lytic bone lesion on radiograph | ||
*Soft tissue and vascular calcification | *Soft tissue and vascular [[calcification]] | ||
*Superior and inferior rib notching | *Superior and inferior rib notching | ||
*Osteonecrosis may be often observed in patients in whom steroid is administered for prevention of renal transplant rejection. | *[[Osteonecrosis]] may be often observed in patients in whom [[steroid]] is administered for prevention of [[Kidney transplantation|renal transplant]] rejection. | ||
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Revision as of 21:16, 28 August 2017
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Overview
X Ray
Primary hyperparathyroidism
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Finding in primary hyperparathyroidism includes:[1]
Secondary and tertiary hyperparathyroidismX-ray is the preferred imaging for diagnosis of secondary hyperparathyroidism as majority of findings are radiological. [2] Findings in secondary and tertiary hyperparathyroidism are often associated with the osteosclerosis of renal osteodystrophy, and the osteomalacia of vitamin D deficiency:
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References
- ↑ Lachungpa T, Sarawagi R, Chakkalakkoombil SV, Jayamohan AE (2014). "Imaging features of primary hyperparathyroidism". BMJ Case Rep. 2014. doi:10.1136/bcr-2013-203521. PMC 3962932. PMID 24614783.
- ↑ Tigges S, Nance EP, Carpenter WA, Erb R (1995). "Renal osteodystrophy: imaging findings that mimic those of other diseases". AJR Am J Roentgenol. 165 (1): 143–8. doi:10.2214/ajr.165.1.7785573. PMID 7785573.