Secondary hyperparathyroidism

Known female patient with chronic renal failure on dialysis.

• Pepper pot skull with speckled appearance especially at high parietal area.
• Subperiosteal bone resorption is evident at radial aspects of proximal and middle phalanges.
• Lamina dura is indistinct/absent around root of teeth.
• Slightly deformed pelvis with questionable inferior pubic rami brown tumors.
• Total arthroplasty right hip.