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April 30, 1973

Section 51.—Hyperparathyroidism-Hyperparathyroidism

JAMA. 1973;224(Suppl_5):773. doi:10.1001/jama.1973.03220190113054

Individuals with functioning tumors of the parathyroid glands are subject to a variety of associated rheumatic disorders, which may occur either singly or in combination.' These include (1) hyperuricemia and gouty arthritis; gouty attacks may occur in the early postoperative period following parathyroidectomy; (2) chondrocalcinosis with episodes of calcium pyrophosphate crystal-induced synovitis (pseudogout), these, too, often occurring after surgery2; calcareous deposits are detectable in articular cartilage, (Fig 80) fibrocartilage of menisci, vertebral disks, and the triangular ligament of the wrist; this latter is one of the most frequent radiographic signs of hyperparathyroidism (Fig 73); (3) a traumatic type of arthritis due to microfractures and collapse of diseasesoftened subchondral bone; and (4) articular cartilage erosion and secondary osteoarthritis resulting from malalignment of joint surfaces following the aforementioned collapse of subchondral bone. In chronic, longcontinued renal failure leading to hyperplasia of the parathyroid glands and secondary hyperparathyroidism, large peri-articular calcium deposits (apatite)