Plain X-ray hands of a young patient with CRF shows signs of secondary hyperparathyroidism:
- irregular, frayed and ill-defined cortical outline, pronounced at radial aspect of middle phalanges –> subperiosteal bone resorption
- multiple lytic expansile lesions –> brown tumours (arrows)
- osteosclerosis
- accentuated trabecular pattern non-essential trabeculae are resorbed; those that remain appear prominent)