Prevalence of radiological findings among cases of severe secondary hyperparathyroidism

CONTEXT AND OBJECTIVE: Patients with end stage renal disease (ESRD) and secondary hyperparathyroidism (HPT2) are prone to develop heterotopic calcifications and severe bone disease. Determination of the sites most commonly affected would decrease costs and patients' exposure to X-ray radiation. The aim here was to determine which skeletal sites produce most radiographic findings, in order to evaluate hemodialysis patients with HPT2, and to describe the most prevalent radiographic findings. DESIGN AND SETTING: This study was cross-sectional, conducted in one center, the Hospital Universitário Clementino Fraga Filho (HUCFF), in Rio de Janeiro, Brazil. METHODS: Whole-body radiographs were obtained from 73 chronic hemodialysis patients with indications for parathyroidectomy due to severe HPT2. The regions studied were the skull, hands, wrists, clavicles, thoracic and lumbar column, long bones and pelvis. All the radiographs were analyzed by the same two radiologists, with great experience in bone disease interpretation. RESULTS: The most common abnormality was subperiosteal bone resorption, mostly at the phalanges and distal clavicles (94% of patients, each). "Rugger jersey spine" sign was found in 27%. Pathological fractures and deformities were seen in 27% and 33%, respectively. Calcifications were presented in 80%, mostly at the forearm fistula (42%), abdominal aorta and lower limb arteries (35% each). Brown tumors were present in 37% of the patients, mostly on the face and lower limbs (9% each). CONCLUSION: The greatest prevalence of bone findings were found on radiographs of the hands, wrists, lateral view of the thoracic and lumbar columns and femurs. The most prevalent findings were bone resorption and ectopic calcifications.

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Main Authors: Lacativa,Paulo Gustavo Sampaio, Franco,Felipe Malzac, Pimentel,José Raimundo, Patrício Filho,Pedro José de Mattos, Gonçalves,Manoel Domingos da Cruz, Farias,Maria Lucia Fleiuss
Format: Digital revista
Language:English
Published: Associação Paulista de Medicina - APM 2009
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802009000200004
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spelling oai:scielo:S1516-318020090002000042009-07-06Prevalence of radiological findings among cases of severe secondary hyperparathyroidismLacativa,Paulo Gustavo SampaioFranco,Felipe MalzacPimentel,José RaimundoPatrício Filho,Pedro José de MattosGonçalves,Manoel Domingos da CruzFarias,Maria Lucia Fleiuss Renal insufficiency, chronic Hyperparathyroidism, secondary Calcinosis Osteitis fibrosa cystica Radiography CONTEXT AND OBJECTIVE: Patients with end stage renal disease (ESRD) and secondary hyperparathyroidism (HPT2) are prone to develop heterotopic calcifications and severe bone disease. Determination of the sites most commonly affected would decrease costs and patients' exposure to X-ray radiation. The aim here was to determine which skeletal sites produce most radiographic findings, in order to evaluate hemodialysis patients with HPT2, and to describe the most prevalent radiographic findings. DESIGN AND SETTING: This study was cross-sectional, conducted in one center, the Hospital Universitário Clementino Fraga Filho (HUCFF), in Rio de Janeiro, Brazil. METHODS: Whole-body radiographs were obtained from 73 chronic hemodialysis patients with indications for parathyroidectomy due to severe HPT2. The regions studied were the skull, hands, wrists, clavicles, thoracic and lumbar column, long bones and pelvis. All the radiographs were analyzed by the same two radiologists, with great experience in bone disease interpretation. RESULTS: The most common abnormality was subperiosteal bone resorption, mostly at the phalanges and distal clavicles (94% of patients, each). "Rugger jersey spine" sign was found in 27%. Pathological fractures and deformities were seen in 27% and 33%, respectively. Calcifications were presented in 80%, mostly at the forearm fistula (42%), abdominal aorta and lower limb arteries (35% each). Brown tumors were present in 37% of the patients, mostly on the face and lower limbs (9% each). CONCLUSION: The greatest prevalence of bone findings were found on radiographs of the hands, wrists, lateral view of the thoracic and lumbar columns and femurs. The most prevalent findings were bone resorption and ectopic calcifications.info:eu-repo/semantics/openAccessAssociação Paulista de Medicina - APMSao Paulo Medical Journal v.127 n.2 20092009-05-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802009000200004en10.1590/S1516-31802009000200004
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language English
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author Lacativa,Paulo Gustavo Sampaio
Franco,Felipe Malzac
Pimentel,José Raimundo
Patrício Filho,Pedro José de Mattos
Gonçalves,Manoel Domingos da Cruz
Farias,Maria Lucia Fleiuss
spellingShingle Lacativa,Paulo Gustavo Sampaio
Franco,Felipe Malzac
Pimentel,José Raimundo
Patrício Filho,Pedro José de Mattos
Gonçalves,Manoel Domingos da Cruz
Farias,Maria Lucia Fleiuss
Prevalence of radiological findings among cases of severe secondary hyperparathyroidism
author_facet Lacativa,Paulo Gustavo Sampaio
Franco,Felipe Malzac
Pimentel,José Raimundo
Patrício Filho,Pedro José de Mattos
Gonçalves,Manoel Domingos da Cruz
Farias,Maria Lucia Fleiuss
author_sort Lacativa,Paulo Gustavo Sampaio
title Prevalence of radiological findings among cases of severe secondary hyperparathyroidism
title_short Prevalence of radiological findings among cases of severe secondary hyperparathyroidism
title_full Prevalence of radiological findings among cases of severe secondary hyperparathyroidism
title_fullStr Prevalence of radiological findings among cases of severe secondary hyperparathyroidism
title_full_unstemmed Prevalence of radiological findings among cases of severe secondary hyperparathyroidism
title_sort prevalence of radiological findings among cases of severe secondary hyperparathyroidism
description CONTEXT AND OBJECTIVE: Patients with end stage renal disease (ESRD) and secondary hyperparathyroidism (HPT2) are prone to develop heterotopic calcifications and severe bone disease. Determination of the sites most commonly affected would decrease costs and patients' exposure to X-ray radiation. The aim here was to determine which skeletal sites produce most radiographic findings, in order to evaluate hemodialysis patients with HPT2, and to describe the most prevalent radiographic findings. DESIGN AND SETTING: This study was cross-sectional, conducted in one center, the Hospital Universitário Clementino Fraga Filho (HUCFF), in Rio de Janeiro, Brazil. METHODS: Whole-body radiographs were obtained from 73 chronic hemodialysis patients with indications for parathyroidectomy due to severe HPT2. The regions studied were the skull, hands, wrists, clavicles, thoracic and lumbar column, long bones and pelvis. All the radiographs were analyzed by the same two radiologists, with great experience in bone disease interpretation. RESULTS: The most common abnormality was subperiosteal bone resorption, mostly at the phalanges and distal clavicles (94% of patients, each). "Rugger jersey spine" sign was found in 27%. Pathological fractures and deformities were seen in 27% and 33%, respectively. Calcifications were presented in 80%, mostly at the forearm fistula (42%), abdominal aorta and lower limb arteries (35% each). Brown tumors were present in 37% of the patients, mostly on the face and lower limbs (9% each). CONCLUSION: The greatest prevalence of bone findings were found on radiographs of the hands, wrists, lateral view of the thoracic and lumbar columns and femurs. The most prevalent findings were bone resorption and ectopic calcifications.
publisher Associação Paulista de Medicina - APM
publishDate 2009
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802009000200004
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