Skeletal findings in secondary hyperparathyroidism

Figure 1: (a) X-ray of the hands showing bilateral acro-osteolysis with resorption of the distal phalangeal tufts (arrows). (b) X-ray of the skull showing abnormal bony mineralization along the patient’s calvarium. (c) X-ray of the right shoulder showing resorption of the distal end of the clavicle and also mild focal subchondral cystic change along the posterior lateral humeral head, better visualized on MRI of the right shoulder (arrows) (d).