Osteitis fibrosa cystica
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Osteitis fibrosa cystica, also known as Von Recklinghausen's disease of bone, is characterized by increased osteoclastic resorption of calcified bone with replacement by fibrous tissue. It may be caused by primary hyperparathyroidism or other causes of the rapid mobilization of mineral salts.
The bone problems associated with the disorder osteitis fibrosa are usually reversible with surgery, except in the case of fluid filled cysts, which require non-surgical attention.
Symptoms
Osteitis fibrosa cystica can lead to bone pain or tenderness, pathological fractures in the arms, legs, or spine, and deformities (bowing of the bones). Being a precursor to the disorder, hyperparathyroidism itself may cause kidney stones, nausea, constipation, fatigue and weakness. Blood tests show a high level of serum calcium and alkaline phosphatase, and low serum phosphorus. X-rays may indicate thin bones, fractures, bowing, and cysts. The cysts may be lined by osteoclasts, filled with fibrous stroma and sometimes blood ("brown tumors"). The skull may look like "ground glass" or "salt and pepper." The outer part of bones may be eroded; the most sensitive area to check is the fingers. Teeth X-rays may also be abnormal.
Differential Diagnosis of Osteitis fibrosa cystica
| Cardiovascular | No underlying causes |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | No underlying causes |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | No underlying causes |
| Trauma | No underlying causes |
| Miscellaneous | No underlying causes |
Treatment
The main treatment for hyperparathyroidism is surgery to remove the abnormal parathyroid gland(s). Newer techniques use radioactive tracers and rapid parathyroid hormone blood tests to make the surgery quicker and easier. If surgery is not possible, drugs can sometimes be used to lower calcium levels.
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
