Hyperparathyroidism x ray: Difference between revisions
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==Overview== | ==Overview== | ||
==X Ray== | ==X Ray== | ||
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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> | |||
*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 | |||
**Phalyngeal tuft erosion (acro-osteolysis) | |||
**Lamina dura around teeth (floating teeth) | |||
*Endoosteal bone resorption | |||
**Widening of medullary cavity | |||
**Thinning of the inner cortex | |||
*Subchondral resorption | |||
**Lateral end of the clavicles | |||
**Symphysis pubis | |||
**Sacroiliac joints | |||
*Subligamentous resorption | |||
**Ischial tuberosity | |||
**Humeral tuberosity | |||
**Trochanters | |||
**Inferior surface of calcaneus | |||
**Inferior margin of lateral clavicle | |||
*Intracortical resorption: cigar/oval-shaped or tunnel-shaped radiolucency in the cortex | |||
*Osteopaenia | |||
*Brown tumours | |||
*Salt and pepper sign in the skull (pepper pot skull) | |||
*Chondrocalcinosis | |||
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: | |||
*Subperiosteal bone resorption | |||
**Radial aspect of middle phalanges of index and long fingers are involved. | |||
*Subchondral resorption | |||
**Hands, hips, shoulders, patellofemoral and sacroiliac joints are involved. | |||
**Hands are involves in the ulnar side. | |||
**Distal interphalangeal and metacarpophalangeal joints are involved. | |||
**Subchondral resorption is very severe. It may lead to bony collapse. | |||
*Subligamentous resorption | |||
**Retrocalcaneal bursa and insertion of planter aponeurosis may be involved. | |||
*Severe osteopenia, may be complicated by pathologic fractures | |||
*Osteosclerosis, e.g. rugger-jersey spine | |||
*Brown tumor | |||
*Amyloid deposition | |||
**May be manifested as lytic bone lesion on radiograph | |||
*Soft tissue and vascular calcification | |||
*Superior and inferior rib notching | |||
*Osteonecrosis may be often observed in patients in whom steroid is administered for prevention of renal transplant rejection. | |||
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[[image:Subperiosteal bone resorption.gif|thumb|600px|Subperiosteal bone resorption - [https://radiopaedia.org/articles/subperiosteal-bone-resorption Source:Radiopedia]]] | |||
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[[image:Brown tumor.gif|thumb|600px|Brown tumors - [https://radiopaedia.org/cases/renal-osteodystrophy-and-brown-tumours-1 Source:Case courtesy of A.Prof Frank Gaillard, Radiopedia]]] | |||
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[[image:Salt-and-pepper-sign-skull compared to normal skull.png|thumb|600px|Normal skull compared to Salt & pepper appearance of skull - [https://radiopaedia.org/cases/21127 Source:Radiopedia]]] | |||
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[[image:Acro-osteolytis.gif|thumb|600px|Acro-osteolytis, terminal tufts erosion - [https://radiopaedia.org/cases/9738 Source:Case courtesy of Dr Andrew Dixon, Radiopedia]]] | |||
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==References== | ==References== |
Revision as of 21:07, 28 August 2017
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Overview
X Ray
Finding in primary hyperparathyroidism includes:[1]
X-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.