Fig. 23.61 
Primary hyperparathyroidism: nephrocalcinosis and a brown tumour. 
Although pathologically about 60 per cent of patients with primary hyperparathyroidism have renal calculi or nephrocalcinosis, the radiological demonstration of such abnormalities is far less common. This coned abdominal film shows extensive nephrocalcinosis of the fine type seen in primary hyperparathyroidism. Generalised loss of bone density is present and a brown tumour has resulted in the partial collapse of the body of the fourth lumbar vertebra.