Multiple endocrine neoplasia type 1 x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2] Ajay Gade MD[3]]

Overview

An x-ray may be helpful in the diagnosis of hyperparathyroidism of multiple endocrine neoplasia type 1. Findings on an x-ray suggestive of primary hyperparathyroidism 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

An x-ray may be helpful in the diagnosis of hyperparathyroidism of multiple endocrine neoplasia type 1. Findings on an x-ray suggestive of primary hyperparathyroidism 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.

Primary hyperparathyroidism

Finding in primary hyperparathyroidism includes:[1]

X-ray Findings Description
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
Subchondral resorption
Subligamentous resorption
Other findings
Subperiosteal bone resorption - Source: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

  1. Lachungpa T, Sarawagi R, Chakkalakkoombil SV, Jayamohan AE (2014). "Imaging features of primary hyperparathyroidism". BMJ Case Rep. 2014. doi:10.1136/bcr-2013-203521. PMC 3962932. PMID 24614783.

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