subperiosteal bone resorption

Subperiosteal bone resorption is the most consistent and specific finding of hyperparathyroidism and is virtually pathognomonic of the condition.

Radiographic features

While the terminal tufts of the phalanges are the most commonly involved bones, many others are involved:

  • tufts of the distal phalanges
  • radial aspect of index and middle finger middle phalanges; erosion begins in the proximal metaphyseal region
  • bandlike zone resorption of the base of the terminal tuft
  • distal end of the clavicles
  • medial tibial plateau
  • medial humeral neck
  • distal ulna
  • superior and inferior margins of the ribs (midclavicular line)
  • lamina dura of skull and teeth
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