Osteitis fibrosa cystica is seen with ?
Ans. is 'a' i.e., Primary hyperparathyroidism The initial osseous lesions associated with primary hyperparathyroidism show merely a decrease in bone density. The full blown osseous manifestations have been referred to as osteitis fibrosa cystica (OFC) or Recklinghausen's disease. Primary hyperparathvroidism (Osteitis fibrosa cystica, von recklinghausen's disease) Primary hyperparathyroidism refers to increased parathormone secretion due to primary pathology in parathyroid gland. Primary adenoma is the most common cause of primary hyperparathyroidism. Rise in parathormone causes increased osteoclastic activity, which resorbs the bone. Consequently, there is increased osteoblastic activity resulting in fibrous replacement of bone and consequent weakening. Parathormone causes increased calcium absorption and increased phosphate excretion by the kidney. The net result in : - T Calcium levels Phosphate levels T Alkaline phosphatase (due to increased osteoblastic activity). Clinical features of Primary hyperparathyroidism (Osteitis fibrosa cystica) Primary hyperparathyroidism is more common in females and occurs in the third to fifth decades of life. o Clinical features are : ? Bone pains : This is the most common initial feature. There is tenderness on palpating the bones, especially in the lower limbs and back. Pain is usually associated with general weakness, pallor and hypotonia. Pathological fracture : Fractures occur with tril injuries and unite in a deformed position. Common sites of fractures are dorso-lumbar spine, neck of the femur and pubic rami. Brown's tumour : This is an expansile bone lesion, a collection of osteoclasts. It commonly affects the maxilla or mandible, though any bone may be affected. Anorexia, nausea, vomiting and abdominal cramps are common presenting complaints. Occasionally, renal colics with haematuria, because of renal calculus, may occur.
Primary hyperparathyroidism
Secondary hyperparathyroidism
Teiary hyperparathyroidism
Pseudohypoparathypoidism