This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Unknown
Totting fence post appearance of femur is seen in: 
Select and explain. 
A. Fibrous dysplasia, B. Hyper parathyroidism, C. Pagets disease, D. Fracture neck of femur
B: Hyper parathyroidism
Answer: B: Hyper parathyroidism 
Explanation: 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