What is the bone lesion associated with hyperparathyroidism?
The primary histologic bone lesion associated with moderate to severe hyperparathyroidism is a high-turnover lesion, sometimes called osteitis fibrosa cystica .
Clinically it is associated with nonspecific bone pain, proximal myopathy.
The serum-intact PTH level is usually higher than 350 to 500 pg/mL. Radiologic features are subperiosteal resorption, Brown tumors, and a mottled and granular salt-and-pepper appearance to the skull. The histologic features include:
• Increased turnover (T) as indicated by increased bone resorption and formation with increased numbers of osteoclasts and osteoblasts, and increased tetracycline uptake
• Abnormal mineralization (M), as indicated by increase of woven bone, peritrabecular fibrosis and there may or may not be increased osteoid
• Generally increased volume (V)
