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01-07-2013 | Original Article

Correlation between hand/wrist and panoramic radiographs in severe secondary hyperparathyroidism

Authors: João César Guimarães Henriques, Julio Cezar de Melo Castilho, Reinhilde Jacobs, José Benedito Oliveira Amorim, Rafaela Rangel Rosa, Caio Vinícius Bardi Matai

Published in: Clinical Oral Investigations | Issue 6/2013

Abstract

Objectives

Hand/wrist and dental radiographs are important for osteoporosis analysis in secondary hyperparathyroidism (SHPT). This study evaluated whether a correlation exists between the effects of the disease on the hands and jaws, and investigated the association between osteoporosis progression in the hands and parathyroid hormone (PTH) levels in chronic kidney disease (CKD) patients.

Materials and methods

Four panoramic radiographic parameters (mental index, mandibular cortical index, trabecular bone pattern, and calcification/resorption) and four corresponding hand/wrist radiographic parameters (metacarpal cortical thickness, phalangeal cortical index, trabecular bone pattern, and calcification/resorption) were applied to investigate possible correlation between the effects of SHPT on the jaws and hands/wrists, by Spearman's correlation coefficient. PTH levels and the hand/wrist radiographic parameters were also tested by spearman's correlation coefficient (p < 0.05). The presence of brown tumors, vascular calcifications, and acroosteolysis on the hands was also evaluated.

Results

Mandibular cortical index was strongly correlated with the phalangeal cortical index (p = 0.000). Phalangeal cortical index and trabecular bone pattern of hand/wrist correlated with PTH levels (0.002 and 0.000, respectively). Brown tumors occurred in four CKD patients, while both vascular calcifications and acroosteolysis were observed in 19 patients.

Conclusion

There is a significant correlation between the morphological changes caused by secondary hyperparathyroidism in hand and jaw bones. The morphological status can be assessed using the mandibular cortical index, besides the phalangeal cortical index. The latter correlates well with parathyroid hormone levels of advanced chronic kidney disease.

Clinical relevance

Panoramic images reveal morphological changes in the jaw bone, indicating likewise changes in the hand/wrist in severe secondary hyperparathyroidism. The severity of the bone changes may be a reflection of the parathyroid hormone levels in advanced chronic kidney disease.

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Title: Correlation between hand/wrist and panoramic radiographs in severe secondary hyperparathyroidism
Authors: João César Guimarães Henriques
Julio Cezar de Melo Castilho
Reinhilde Jacobs
José Benedito Oliveira Amorim
Rafaela Rangel Rosa
Caio Vinícius Bardi Matai
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: Clinical Oral Investigations / Issue 6/2013
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-012-0842-x

At a glance: The STEP trials

Springer Medicine

Correlation between hand/wrist and panoramic radiographs in severe secondary hyperparathyroidism

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

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