Primary Hyperparathyroidism Presenting as a Distal Femur Pathologic Fracture in an Adolescent: A Case Report.
Taylor Anthony, Alexander J Baur, Ashwin Suresh et al.
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Case in brief
A 17-year-old boy presented with a pathologic fracture of the distal femur, accompanied by bilateral distal femoral metadiaphyseal lytic lesions. Evaluation revealed these lesions were brown tumors linked to primary hyperparathyroidism caused by a parathyroid adenoma. Management involved bone biopsy, curettage, grafting, and retrograde locked intramedullary nailing, followed by partial parathyroidectomy. The other lesion was treated with corrective osteotomy and stabilization.
Diagnostic / clinical pearl
Clinicians should consider primary hyperparathyroidism in adolescents presenting with pathologic fractures and multifocal lytic bone lesions, as these may indicate underlying metabolic disorders.
Why it matters
Recognizing the skeletal manifestations of primary hyperparathyroidism can lead to timely biochemical evaluation and appropriate management, potentially preventing further complications.