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</div><div><span>Osteitis fibrosa</span></div></div>
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</a><h1 class="with-also" itemprop="name">Osteitis fibrosa</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Osteitis fibrosa is a complication of <a test="test" href="./001215.htm">hyperparathyroidism</a>, a condition in which overactive parathyroid glands cause certain bones to become abnormally weak and deformed.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>The parathyroid glands are 4 tiny glands in the neck. These glands produce parathyroid hormone (PTH). PTH helps regulate calcium, phosphorus, and vitamin D levels in the blood and is important for healthy bones.</p><p>Too much parathyroid hormone (hyperparathyroidism) can lead to increased bone breakdown, which can cause bones to become weaker and more fragile. Many people with hyperparathyroidism eventually develop <a test="test" href="./000360.htm">osteoporosis</a>. Not all bones respond to PTH in the same way. Some develop abnormal areas where the bone is very soft and has almost no calcium in it. This is osteitis fibrosa.</p><p>In rare cases, <a test="test" href="./007264.htm">parathyroid cancer</a> causes osteitis fibrosa.</p><p>Osteitis fibrosa is now very rare in people who have hyperparathyroidism and good access to medical care. It is more common in people who develop hyperparathyroidism at a young age, or have untreated hyperparathyroidism for a long time.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Osteitis fibrosa may cause bone pain or tenderness. There may be fractures (breaks) in the arms, legs, or spine, or other bone problems. </p><p>Hyperparathyroidism itself may cause any of the following:</p><ul><li>Nausea</li><li>Constipation</li><li>Fatigue</li><li>Frequent urination</li><li>Weakness</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Blood tests show a high level of calcium, parathyroid hormone, and alkaline phosphatase (a bone chemical). Phosphorus level in the blood may be low.</p><p>
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X-rays may show thin bones, fractures, bowing, and <a test="test" href="./003240.htm">cysts</a>. <a test="test" href="./003801.htm">Teeth x-rays</a> may also be abnormal.</p><p>A <a test="test" href="./003808.htm">bone x-ray</a> or bone density test may be done. People with hyperparathyroidism are more likely to have osteopenia (thin bones) or osteoporosis (very thin bones) than to have full-blown osteitis fibrosa.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Most of the bone problems from osteitis fibrosa can be reversed with surgery to remove the abnormal parathyroid gland(s). Some people may choose not to have surgery, and instead be followed with blood tests and bone measurements.</p><p>If surgery is not possible, medicines can sometimes be used to lower the blood calcium level.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Complications of osteitis fibrosa include any of the following: </p><ul><li>Bone fractures</li><li>Deformities of bone</li><li>Pain</li><li>Problems due to hyperparathyroidism, such as <a test="test" href="./000458.htm">kidney stones</a> and <a test="test" href="./000501.htm">kidney failure</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Contact your health care provider if you have bone pain, tenderness, or symptoms of hyperparathyroidism.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Routine blood tests done during a medical checkup or for another health problem usually detect a high calcium level before severe damage is done.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Osteitis fibrosa cystica; Hyperparathyroidism - osteitis fibrosa; Brown tumor of bone</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/8890t.jpg" alt="Parathyroid glands" title="Parathyroid glands" class="side-img"/><a href="../imagepages/8890.htm">Parathyroid glands</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Nadol JB, Quesnel AM. Otologic manifestations of systemic disease. In: Flint PW, Francis HW, Haughey BH, et al, eds. <em>Cummings Otolaryngology: Head and Neck Surgery.</em> 7th ed. Philadelphia, PA: Elsevier; 2021:chap 151.</p><p>Patsch JM, Krestan CR. Metabolic and endocrine skeletal disease. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. <em>Grainger & Allison's Diagnostic Radiology.</em> 7th ed. Philadelphia, PA: Elsevier; 2021:chap 43.</p><p>Thakker RV. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Cooney KA, eds. <em>Goldman-Cecil Medicine</em>. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 227.</p><p>Walker MD, Bilezikian JP. Primary hyperparathyroidism. In: Robertson RP, ed. <em>DeGroot's Endocrinology</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 54.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 5/20/2024</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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