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Salt and pepper skull

Case contributed by Dra. María Ferretti Diez
Diagnosis almost certain

Presentation

Chronic renal failure. Candidate for renal transplant. Increased parathyroid hormone.

Patient Data

Age: 60 years
Gender: Male
x-ray

Sclerosis is seen alternated with radiolucent areas at the level of the bones of the skull, adopting a "salt and pepper" pattern.

Case Discussion

These images show the presence of multiple radiolucent punctate images scattered throughout the skull due to bone resorption. There is a loss of distinction between internal and external tables, Depressed glass appearance and dotted ossification. Findings in relation to secondary hyperparathyroidism.

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