#neprhology

[teachingrounds]

Lucent lesions of bone can be "Brown tumors" of bone, caused by hyperparathyroidism (HPT, either primary or secondary). A patient must have a history of hyperparathyroidism or renal failure (secondary HPT) to consider this diagnosis.

Case:

Bilateral hand radiograph of a young patient with chronic renal failure shows signs of secondary hyperparathyroidism:

--irregular, frayed and ill-defined cortical outline, pronounced at radial aspect of middle phalanges –> subperiosteal bone resorption

--multiple lytic expansile lesions –> brown tumors (arrows)

--osteosclerosis

--accentuated trabecular pattern

Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 36356