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Case of the Week 328 
What's the most likely diagnosis?
- 51 year-old man with elevated creatinine
- Psoriasis
- Metastatic disease
- Sarcoid
- Hyperparathyroidism
- Reiter's syndrome
Additional Images - Frontal view of same hand
Answer:
4. Hyperparathyroidism
More (Click Discussion Tab)
Hyperparathyroidism
Primary hyperparathyroidism
- Overproduction of parathyroid hormone (PTH) with associated hypercalcemia
- Most frequent cause: single adenoma in 85% of cases
- Clinical: Bones (osteopenia, brown tumors), stones (renal calculi) and abdominal groans (ulcer disease)
- Laboratory: increased parathormone level with hypercalcemia is diagnostic of primary hyperparathyroidism
- Imaging of the parathyroid glands: radiolabeled technetium 99m sestamibi persists in adenomas on nuclear scans
- Brown tumors are more common than in secondary form
- Treatment: Symptomatic patients are usually treated by surgically removing abnormal gland(s)
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LearningRadiology.com is an award-winning educational site aimed primarily at medical students and radiology residents-in-training, containing lectures, handouts, images, Cases of the Week, archives of case quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, cardiac, and bone radiology.
