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Osteitis fibrosa

Osteitis fibrosa cystica; Hyperparathyroidism - osteitis fibrosa

 

Osteitis fibrosa is a complication of hyperparathyroidism, a condition in which certain bones become abnormally weak and deformed.

Causes

 

The parathyroid glands are 4 tiny glands in the neck. These glands produce parathyroid hormone (PTH). PTH helps control calcium, phosphorus, and vitamin D levels in the blood and is important for healthy bones.

Too much parathyroid hormone (hyperparathyroidism) can lead to increased bone breakdown, which can cause bones to become weaker and more fragile. Many people with hyperparathyroidism develop osteoporosis. Not all bones respond to PTH in the same way. Some develop abnormal areas where the bone is very soft and has almost no calcium in it. This is osteitis fibrosa.

In rare cases, parathyroid cancer causes osteitis fibrosa.

 

Symptoms

 

Osteitis fibrosa may cause bone pain or tenderness. There may be fractures (breaks) in the arms, legs, or spine, or other bone problems.

Hyperparathyroidism itself may cause any of the following:

  • Nausea
  • Constipation
  • Fatigue
  • Frequent urination
  • Weakness

 

Exams and Tests

 

Blood tests show a high level of calcium, parathyroid hormone, and alkaline phosphatase (a bone chemical). Phosphorus level in the blood may be low.

X-rays may show thin bones, fractures, bowing, and cysts. Teeth x-rays may also be abnormal.

A bone x-ray may be done. People with hyperparathyroidism are more likely to have osteopenia (thin bones) or osteoporosis (very thin bones) than to have full-blown osteitis fibrosa.

 

Treatment

 

Most of the bone problems from osteitis fibrosa can be reversed with surgery to remove the abnormal parathyroid gland(s). Some people may choose not to have surgery, and instead be followed with blood tests and bone measurements.

If surgery is not possible, medicines can sometimes be used to lower calcium level.

 

Possible Complications

 

Complications of osteitis fibrosa include any of the following:

  • Bone fractures
  • Deformities of bone
  • Pain
  • Problems due to hyperparathyroidism, such as kidney stones and kidney failure

 

When to Contact a Medical Professional

 

Call your health care provider if you have bone pain, tenderness, or symptoms of hyperparathyroidism.

 

Prevention

 

Routine blood tests done during a medical checkup or for another health problem usually detect a high calcium level before severe damage is done.

 

 

References

Silverberg SJ, Bilezikian JP. Primary hyperparathyroidism. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 63.

Thakker RV. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 245.

 
  • Bone tumor

    Bone tumor - illustration

    An abnormal growth of cells within the bone that may be benign or malignant (cancerous).

    Bone tumor

    illustration

  • Parathyroid glands

    Parathyroid glands - illustration

    The 4 parathyroid glands are located near or attached to the back side of the thyroid gland and produce pararthyroid hormone (PTH). Parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the blood and bone by maintaining a balance between the mineral levels in the blood and the bone.

    Parathyroid glands

    illustration

    • Bone tumor

      Bone tumor - illustration

      An abnormal growth of cells within the bone that may be benign or malignant (cancerous).

      Bone tumor

      illustration

    • Parathyroid glands

      Parathyroid glands - illustration

      The 4 parathyroid glands are located near or attached to the back side of the thyroid gland and produce pararthyroid hormone (PTH). Parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the blood and bone by maintaining a balance between the mineral levels in the blood and the bone.

      Parathyroid glands

      illustration

    Self Care

     

      Tests for Osteitis fibrosa

       

         

        Review Date: 5/2/2016

        Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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