Parathyroid adenoma x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Overview

X-ray is helpful in diagnosis of parathyroid adenoma. Finding in X-ray suggestive of parathyroid adenoma includes subperiosteal bone resorption, endoosteal bone resorption, subchondral resorption, subligamentous resorption, intracortical resorption, osteopenia, brown tumors, salt and pepper sign in the skull (pepper pot skull), and chondrocalcinosis.

X Ray

Finding in X-ray suggestive of parathyroid adenoma includes:

• Subperiosteal bone resorption
  • Classically affects the radial aspects of the proximal and middle phalanges of the index and middle fingers
  • Medial aspect of tibia, femur, humerus
  • Phalangeal 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
• Osteopenia
• Brown tumors
• Salt and pepper sign in the skull (pepper pot skull)
• Chondrocalcinosis

Subperiosteal bone resorption - Source:Radiopedia	Brown tumors - Source:Case courtesy of A.Prof Frank Gaillard, Radiopedia
Normal skull compared to Salt & pepper appearance of skull - Source:Radiopedia	Acro-osteolytis, terminal tufts erosion - Source:Case courtesy of Dr Andrew Dixon, Radiopedia

References

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