A Colour Atlas of Bone Disease (Wolfe Medical Atlases) by Victor Parsons

By Victor Parsons

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25 DHCcl Short-term 'Calcium . 25-DHCC. +PTH 24,25 KIDNEY CD o + DHCC = 1a hydroxylase =24 hydroxylas I. Primary hyperparathyroidism Causes of primary hyperparathyroidism are: - adenoma (or two adenomas) - carcinoma (rare) - hyperplasia of water clear cells or chief cells (rare) Adenoma of one or two parathyroids accounts for more tha~ ~O per cent of cases of primary hyperparathyrOIdism. Although a solitary adenoma of one of the lower parathyroids is the rule, about 6 per cent of patients have two adenomas.

Lines The skull when affected is grossly thickened and the sutures are obliterated (156). Occasionally at an early stage of the disease an area may be so rarefied as to suggest a bony defect (osteoporosis circumscripta 157). Thickening of the skull may 50 153 Paget's disease - osteoblastic activity -. ,"'~" ,;-. 154 I'aget's bone resorption has been followed by deposition of new bone. E x 150). The marrow of the affected bone is replaced by cellular, extremely vascular, fibrous tissue.

I. J' 141 Steroid 144 Osteoporosis osteoporosis in thyrotoxicosis ~ , . ,,I , 'w'" , fractures (144) sometimes the causalion is multifaclorial: for example a post-menopausal female may be immobilised by rheumatoid arthritis and treated with corticosteroids . ', I'~ . ' .. :~, ,;. , to" ,1' 'r .. \J ~_. 47 145 Juvenile osh'Ooorosis 146 Osteoporosis cirrhosis in - transient osteoporosis (juvenile osteoporosis) in childhood affects a small group of apparently healthy children who become acutely osteoporotic.

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