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Hyperparathyroidism

Hyperparathyroidism is the effect of excess parathyroid hormone in the body. It can be primary, secondary or tertiary. There many characteristic imaging features predominantly involving the skeletal system.

Pathology

Increased levels of parathyroid hormone (PTH) lead to increased osteoclastic activity. The resultant bone resortpion produces cortical thinning (subperiosteal resorption) and osteopaenia.

Sub types
  1. primary hyperparathyroidism - a parathyroid adenoma is the commonest cause ( ≈ 80%) followed by parathyroid hyperplasia ( ≈ 15%) 2
  2. secondary hyperparathyroidism - a diffuse, adenomatous hyperplasia, renal osteodystrophy
  3. tertiary hyperparathyroidism - an autonomous parathyroid adenoma caused by the chronic overstimulation of hyperplastic glands in renal insufficiency
Associations

Both syndromes are associated with parathyroid hyperplasia.

Radiographic features

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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