The radiological changes in hyperparathyroidism are:
classically, subperiosteal bone resorption - most often on the radial aspect of the middle phalanges of the fingers; the extent correlates well with the increased serum alkaline phosphatase
loss of lamina dura - the thin layer of compact bone forming the sheath for the tooth socket - a late sign
extensive bone resorption in the skull gives a stippled 'pepper pot' appearance
cystic lesions - brown tumours - may occur elsewhere in the skeleton - appear as rounded radiolucent lesions which are trabeculated - but are less common and a late sign
resorption of metaphyseal bone in children gives rise to crippling skeletal deformities
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