Totting fence post appearance of femur is seen in:: (A) Fibrous dysplasia, (B) Hyper parathyroidism, (C) Pagets disease, (D) Fracture neck of femur
Answer is B. Ans: B (Hyperparathyroidism) Ref: Harrison's Principles of Internal Medicine, 18th ed. and Internet Source Explanation: Renal Osteodystrophy CRF leading on to hyperparathyroidism Signs of chronic renal failure Findings of osteomalacia Hyperparathyroidism Bone sclerosis Rugger jersey spine Totting fence post appearance: Due to Rickets + Hyperparathyroidism In children, metaphyseal changes resembling rickets are seen, which together with cortical erosions can give rise to the so-called Totting fence-post' appearance, particularly at the femoral neck. Looser's zone