Bone Under Siege: A case of severe Skeletal Disease in Primary Hyperparathyroidism

Abstract

Primary hyperparathyroidism can lead to rare but severe bone disease. We report a 28-year-old male with chronic generalized body aches, fatigue, weight loss, difficulty walking, and painful limb movements over several months. Symptoms progressed to multiple pathological fractures of the left femur, right femoral neck, left tibia, left proximal humours, and left proximal radius and ulna, confirmed radio logically. Laboratory evaluation revealed elevated PTH and calcium with low phosphorus and vitamin D. Bone biopsy from the left tibia showed giant cell lesions consistent with osteitis fibrosa cystica. Ultrasound confirmed a parathyroid adenoma, which was surgically removed along with partial thyroidectomy. Postoperative follow-up showed normalized PTH, calcium, and vitamin D levels with complete symptom resolution. This case highlights the importance of early detection and surgical management in primary hyperparathyroidism.