Orthonotes
Orthonotes
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Hyperparathyroidism and Bone

Excess PTH causes cortical bone loss via RANKL-mediated osteoclast activation; classic radiology: subperiosteal resorption, salt‑and‑pepper skull, brown tumors. Primary (adenoma), secondary (CKD/vit D deficiency), tertiary (autonomous) forms dictate biochemistry and treatment. DEXA: cortical loss at one‑third radius; labs—↑PTH, ↑ALP; Ca high in primary/tertiary, low‑normal in secondary; phosphate low in primary, high in CKD. Orthopaedic issues: fragility fractures, brown tumors, tendon ruptures;...