Last revised by Craig Hacking on 28 Nov 2022

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

It accounts for the 'H' in the popular mnemonic for lucent bone lesions FEGNOMASHIC.

Parathyroid hormone affects multiple organs. The most common symptoms are bone pain, chronic fatigue, polyuria, headache, decreased concentration and depression. Also, patients can present with complications like renal stones, fractures, cardiac arrhythmia, and hypertension.

Hyperparathyroidism is supported biochemically by either an elevated serum parathyroid hormone level or an inappropriately normal level in the setting of hypercalcemia.

Hyperparathyroidism can occur in the context of the following conditions from parathyroid hyperplasia or less commonly multiple parathyroid adenomas 5:

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

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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