dominant inheritance

Age: onset in 2^nd decade; M÷F = 3÷1

• sensory changes in hands + feet
• destruction of nails; joint hypermobility
• swelling of plantar of foot with deep wide ulcer + ejection of bone fragments

• Skull
  • wormian bones
  • craniosynostosis
  • basilar impression
  • protuberant occiput
  • resorption of alveolar processes + loss of teeth
• Spine
  • spinal osteoporosis ± fracture
  • kyphoscoliosis + progressive decrease in height

DDx: Hyperparathyroidism