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Radicular lower extremity pain as the first symptom of primary hyperparathyroidism

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Abstract

Clinical symptoms of hyperparathyroidism are generally nausea, vomiting, fatigue, constipation, and hypotonicity of the muscles and ligaments; bone pain and tenderness are also seen but are more common in secondary hyperparathyroidism. We report a histologically confirmed case of a 28-year-old man whose sole symptom of primary hyperparathyroidism was lower extremity radicular pain due to a vertebral brown tumor. Magnetic resonance imaging demonstrated brown tumor to be hyperintense on T2-weighted and slightly hypointense on T1-weighted sequences; it showed intense contrast enhancement with gadolinium. Because brown tumors usually contain hemosiderin a short T2 should have been expected, but this was not seen in our case. Healing resulted in decreasing contrast enhancement on T1-weighted sequences and increasingly short T2. To our knowledge, this is the first report of a lumbar vertebral brown tumor associated with primary hyperparathyroidism.

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Authors and Affiliations

  1. Toolo Trauma Center, Helsinki University Central Hospital, Topeliuksenkatu 5, 00029, Helsinki, Finland

    Antti O. T. Mustonen, Martti J. Kiuru & Seppo K. Koskinen

  2. Department of Pathology, Haartman Institute, University of Helsinki, 00014, Helsinki, Finland

    Anders Stahls & Tom Bohling

  3. Department of Orthopedics and Traumatology, Helsinki University Central Hospital, 00029, Helsinki, Finland

    Aarne Kivioja

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  1. Antti O. T. Mustonen
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  2. Martti J. Kiuru
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  3. Anders Stahls
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  4. Tom Bohling
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  5. Aarne Kivioja
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  6. Seppo K. Koskinen
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Correspondence to Antti O. T. Mustonen.

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Mustonen, A.O.T., Kiuru, M.J., Stahls, A. et al. Radicular lower extremity pain as the first symptom of primary hyperparathyroidism. Skeletal Radiol 33, 467–472 (2004). https://doi.org/10.1007/s00256-004-0803-9

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  • DOI: https://doi.org/10.1007/s00256-004-0803-9

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