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Hyperparathyroidism

 

 

 

Primary

Secondary

Tertiary

Serum

Calcium

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« or ¯

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Phosphorous

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Alkaline Phosphatase

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Urine

Calcium

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Phosphorous

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  • Primary Hyperparathyroidism


  •  
    • Due mostly to adenoma of one or more glands with increase in chief or oxyphil cells

    • Rarely hyperplasia

    • Even rarer with carcinoma

    • Skeletal lesions have been called osteitis fibrosa cystica or Von Recklinghausen’s

    • 15-20% who have hyperparathyroidism have x-ray findings

    • Absence of subperiosteal resorption strongly mitigates against the diagnosis

    • Brown tumors-benign, well-defined, radiolucent lesion

      • Cystic lesion

      • May be multiple and look like mets

      • Pathologic fractures are common

    • Soft tissue calcification is more common in secondary, except for knee medial meniscus calcification which is more common in primary

 

  • Secondary hyperparathyroidism

    • Hyperplasia

    • Rarely adenoma

    • Mostly chief or clear cell

    • Brown tumors less common

    • Soft tissue calcification more common

    • Calcified deposits around joints may mimic tumoral calcinosis

 

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