Brown tumours sometimes occur in primary hyperparathyroidism but are relatively uncommon in secondary hyperparathyroidism. This PA film of the wrist shows the typical appearance of brown tumours. Osteolucent bony defects are present in the distal radius and ulna, the base of the third metacarpal and the proximal phalanx of the little finger. The bone density is generally decreased. After parathyroidectomy brown tumours fill slowly with new bone from the periphery. Incomplete healing results in an appearance which may closely resemble that of fibrous dysplasia.
