Skeletal Alterations in Hyperparathyroidism: Determination of Bone Formation, Resorption and Morphologic Changes by Microradiography

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Abstract
Specimens of posterior iliac crest bone from 26 cases of primary hyperparathyroidism and 21 control cases were studied by microradiography. Surfaces of bone formation and of bone resorption were directly assessed and quantitatively expressed as a percentage of the total surface in the section (Jowsey method). All cases of hyperparathyroidism demonstrated increased bone resorption; 4 cases also had increased bone formation. A significant correlation was found between the preoperative serum calcium concentration and the degree of bone resorption. No correlation was observed between the amount of porosity in the bone and the degree of bone formation or between the dietary intake of calcium and the extent of the disease (except perhaps in 3 cases with unusually low intakes). A spectrum of morphologic changes was seen, ranging from minimal alterations limited to an increase in resorblng surfaces to grossly abnormal metaplastic bone. It is concluded that most, if not all, hyperparathyroid patients have some degree of skeletal abnormality.