title: Radicular lower extremity pain as the first symptom of primary hyperparathyroidism.
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.
authors.affiliation: Toolo Trauma Center, Helsinki University Central Hospital, Topeliuksenkatu 5, 00029, Helsinki, Finland. antti.mustonen@hus.fi
authors.forename: Antti O T
authors.initials: AO
authors.lastname: Mustonen
authors.forename: Martti J
authors.initials: MJ
authors.lastname: Kiuru
authors.forename: Anders
authors.initials: A
authors.lastname: Stahls
authors.forename: Tom
authors.initials: T
authors.lastname: Bohling
authors.forename: Aarne
authors.initials: A
authors.lastname: Kivioja
authors.forename: Seppo K
authors.initials: SK
authors.lastname: Koskinen
mesh_terms: D000236:Adenoma / Q000150:complications / Q000175:diagnosis; D000328:Adult; D006101:Granuloma, Giant Cell / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D010282:Parathyroid Neoplasms / Q000150:complications / Q000175:diagnosis; D012585:Sciatica / Q000209:etiology*; D013122:Spinal Diseases / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed