Patellar fracture: Atypical presentation of parathyroid bone disease

摘要

A 21 -year-old male was admitted to the orthopaedic and trauma department following a left knee injury. On examination, he appeared dehydrated and had left-sided knee pain. Radiological investigations revealed a left patellar fracture (Figure 1A); in addition, incidental distal femoral and proximal tibial bone cysts were present. Routine serum biochemistry revealed severe hypercalcaemia with a corrected calcium 4.03mmol/l. Initial management of hypercalcaemia included 41/24 hr intravenous (IV) saline (from Day 1), 30 mg IV pamidronate (Day 2) and 40 mg iv furosemide (Day 4), with improvement in serum calcium (3.01 mmol/l on Day 8).