National Board of Chiropractic Examiners (NBCE) Practice Test

Granular deossification of the skull is most characteristic of which condition?

1. Osteoporosis

2. Hyperparathyroidism

3. Paget's disease

4. Multiple myeloma

The correct answer is: Hyperparathyroidism

Granular deossification of the skull is most closely associated with hyperparathyroidism. This condition results from an excess of parathyroid hormone, which leads to increased bone resorption. In hyperparathyroidism, the elevated levels of this hormone cause the bones to lose calcium, which can present as a characteristic radiographic pattern of granular or moth-eaten appearance in the skull. This pattern illustrates the changes in bone density and structure that occur due to the underlying metabolic imbalance. In contrast, osteoporosis typically results in a more generalized decrease in bone density without the granular appearance. Paget's disease is characterized by disorganized bone remodeling, leading to areas of increased bone density and deformity, rather than granular deossification. Multiple myeloma may produce lytic bone lesions but does not specifically produce the granular deossification pattern seen in hyperparathyroidism. Thus, the identification of granular deossification as a hallmark of hyperparathyroidism is key in differentiating it from other conditions affecting bone structure.