Master's Diagnostic medicine

10y boy came with fracture femur, Hb- 11.5g/dL, ESR- 18mm/hr Serum calcium- 12.8g/dL Serum Phosphorus- 2.3g/dL Alkaline phosphatase- 28 Blood urea- 32mg/dL. What could be the diagnosis, management?

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By looking investigations Calcium is high Phosphorus is low See for hyperparathyroidism Bones are fragile in it Adv: PTH level USG parathyroid region

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Rule out osteosarcoma Rule out hyperparathyroidism Rule out vitamin D 3 deficiency Genetic disorder

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Yes dis proportionate calcium and phosphorus levels suggest hyperparathyroidism Needs to confirm

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Detailed clinical history.. family history.. and x ray evaluation are mandatory for specific diagnosis... Dd includes.. Trauma Tumour... benign or malignant.. or tumor like lesions Hyperparathyroidism Vit d deficiency Osteopetrosis.. and other genetic diseases.

Was it traumatic fracture? Does Xray femur shows osteolytic areas ? S calcium is elevated. PTH can be estimated US of neck to R/O parathyroid nodules.

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Any history of fall? Since calcium is high phosphorus on a low side. Rule out infection Check PTH and serum vitD levels

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In addition to above, evaluation for kidneys.. For Renal osteodystrophy

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