Distal phalangeal brachydactyly and osteosclerosis in a case of secondary hyperparathyroidism.

A case of severe hyperparathyroidism (HPT), secondary to chronic renal failure, with massive distal phalangeal osteolysis is reported. After parathyroidectomy, brachydactyly and osteosclerosis of the distal phalanges were observed; the phalanx of the thumbs healed with shortened and sclerotic beaked appearance. These radiographic findings are actually uncommon because of more efficient treatment of renal osteodystrophy. Pathophysiology of this bone sclerotic lesion is discussed, and other causes of distal phalangeal osteosclerosis are mentioned.