–Subperiosteal resorption along radial aspects of middle phalanges, especially 2nd and 3rd

–Brown tumors (lytic lesions)

–Soft tissue Ca+


–Cortical tunneling, osteopenia, subchondral resorption mimicking erosions

–Occasionally, diffuse osteosclerosis

–Vascular Ca+: usually w/secondary hyperparathyroidism from renal failure

–Salt and pepper skull

–Amyloidosis can be seen in pts undergoing dialysis, leading to findings in joints and spine that can appear similar to infection

DDx distal clavicle resorption:

Unilateral :

  • RA,
  • hyperparathyroidism,
  • trauma (osteolysis),
  • cleidocranial dysplasia,
  • mets/myeloma


  • RA,
  • hyperparathyroidism,
  • cleidocranial dysplasia

–Get hand XR

Rugger jersey spine

  • Sclerosis of vertebral body endplates
  • Differentiate from osteopetrosis (“bone in a bone” or sandwich vertebrae) and Paget (“picture frame,” enlarged vertebrae)

– Get hand XR