{"id":"https://openalex.org/W7214908421","doi":"https://doi.org/10.2106/jbjs.cc.26.00240","title":"Primary Hyperparathyroidism Presenting as a Distal Femur Pathologic Fracture in an Adolescent","display_name":"Primary Hyperparathyroidism Presenting as a Distal Femur Pathologic Fracture in an Adolescent","publication_year":2026,"publication_date":"2026-07-01","ids":{"openalex":"https://openalex.org/W7214908421","doi":"https://doi.org/10.2106/jbjs.cc.26.00240","pmid":"https://pubmed.ncbi.nlm.nih.gov/42809647"},"language":"en","primary_location":{"id":"doi:10.2106/jbjs.cc.26.00240","doi":"https://doi.org/10.2106/jbjs.cc.26.00240","is_oa":false,"landing_page_url":"https://doi.org/10.2106/jbjs.cc.26.00240","pdf_url":null,"source":{"id":"https://openalex.org/S4210176812","display_name":"JBJS Case Connector","issn_l":"2160-3251","issn":["2160-3251"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline","norway-1","poland-20","russia-white-list-4"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JBJS Case Connector","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5075179361","display_name":"Taylor Anthony","orcid":"https://orcid.org/0000-0002-0850-3898","observed_orcids":["https://orcid.org/0000-0002-0850-3898"]},"institutions":[{"id":"https://openalex.org/I2801053641","display_name":"Valley Hospital Medical Center","ror":"https://ror.org/03a71g847","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2801053641"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Taylor Anthony","raw_affiliation_strings":["Department of Orthopedics, Orthopaedic Surgery, Valley Hospital Medical Center, Las Vegas, Nevada"],"raw_orcid":"https://orcid.org/0000-0002-0850-3898","affiliations":[{"raw_affiliation_string":"Department of Orthopedics, Orthopaedic Surgery, Valley Hospital Medical Center, Las Vegas, Nevada","institution_ids":["https://openalex.org/I2801053641"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5062718297","display_name":"Alexander J. Baur","orcid":"https://orcid.org/0009-0002-9820-6025","observed_orcids":["https://orcid.org/0009-0002-9820-6025"]},"institutions":[{"id":"https://openalex.org/I2801053641","display_name":"Valley Hospital Medical Center","ror":"https://ror.org/03a71g847","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2801053641"]},{"id":"https://openalex.org/I67789559","display_name":"Liberty University","ror":"https://ror.org/00w4qrc49","country_code":"US","type":"education","lineage":["https://openalex.org/I67789559"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Alexander J. Baur","raw_affiliation_strings":["Department of Orthopedics, Center for Research, Liberty University, Lynchburg, Virginia","Department of Orthopedics, Orthopaedic Surgery, Valley Hospital Medical Center, Las Vegas, Nevada"],"raw_orcid":"https://orcid.org/0009-0002-9820-6025","affiliations":[{"raw_affiliation_string":"Department of Orthopedics, Center for Research, Liberty University, Lynchburg, Virginia","institution_ids":["https://openalex.org/I67789559"]},{"raw_affiliation_string":"Department of Orthopedics, Orthopaedic Surgery, Valley Hospital Medical Center, Las Vegas, Nevada","institution_ids":["https://openalex.org/I2801053641"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5153677059","display_name":"Ashwin Suresh","orcid":"https://orcid.org/0009-0009-9569-2882","observed_orcids":["https://orcid.org/0009-0009-9569-2882"]},"institutions":[{"id":"https://openalex.org/I138006243","display_name":"University of Arizona","ror":"https://ror.org/03m2x1q45","country_code":"US","type":"education","lineage":["https://openalex.org/I138006243"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Ashwin Suresh","raw_affiliation_strings":["University of Arizona, Tucson, Arizona"],"raw_orcid":"https://orcid.org/0009-0009-9569-2882","affiliations":[{"raw_affiliation_string":"University of Arizona, Tucson, Arizona","institution_ids":["https://openalex.org/I138006243"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5153574997","display_name":"Jasmine Lopez","orcid":"https://orcid.org/0009-0009-0468-2516","observed_orcids":["https://orcid.org/0009-0009-0468-2516"]},"institutions":[{"id":"https://openalex.org/I1330342723","display_name":"Mayo Clinic","ror":"https://ror.org/02qp3tb03","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723"]},{"id":"https://openalex.org/I4210125099","display_name":"Mayo Clinic in Arizona","ror":"https://ror.org/03jp40720","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723","https://openalex.org/I4210125099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jasmine Lopez","raw_affiliation_strings":["Department of Orthopedics, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona"],"raw_orcid":"https://orcid.org/0009-0009-0468-2516","affiliations":[{"raw_affiliation_string":"Department of Orthopedics, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona","institution_ids":["https://openalex.org/I1330342723","https://openalex.org/I4210125099"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135874223","display_name":"Kevin Mo","orcid":"https://orcid.org/0000-0002-7728-0093","observed_orcids":["https://orcid.org/0000-0002-7728-0093"]},"institutions":[{"id":"https://openalex.org/I2801053641","display_name":"Valley Hospital Medical Center","ror":"https://ror.org/03a71g847","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2801053641"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kevin Mo","raw_affiliation_strings":["Department of Orthopedics, Orthopaedic Surgery, Valley Hospital Medical Center, Las Vegas, Nevada"],"raw_orcid":"https://orcid.org/0000-0002-7728-0093","affiliations":[{"raw_affiliation_string":"Department of Orthopedics, Orthopaedic Surgery, Valley Hospital Medical Center, Las Vegas, Nevada","institution_ids":["https://openalex.org/I2801053641"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5067342723","display_name":"Mohan V. Belthur","orcid":"https://orcid.org/0000-0001-5279-0591","observed_orcids":["https://orcid.org/0000-0001-5279-0591"]},"institutions":[{"id":"https://openalex.org/I4210124153","display_name":"Phoenix Children's Hospital","ror":"https://ror.org/03ae6qy41","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210124153"]},{"id":"https://openalex.org/I4405259572","display_name":"University of Arizona College of Medicine- Phoenix","ror":"https://ror.org/02drhvq25","country_code":"US","type":"education","lineage":["https://openalex.org/I138006243","https://openalex.org/I4405259572"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mohan V. Belthur","raw_affiliation_strings":["Department of Orthopedics, Orthopaedic Surgery, Phoenix Children's Hospital, Phoenix, Arizona","Department of Orthopedics, University of Arizona College of Medicine, Phoenix, Arizona"],"raw_orcid":"https://orcid.org/0000-0001-5279-0591","affiliations":[{"raw_affiliation_string":"Department of Orthopedics, Orthopaedic Surgery, Phoenix Children's Hospital, Phoenix, Arizona","institution_ids":["https://openalex.org/I4210124153"]},{"raw_affiliation_string":"Department of Orthopedics, University of Arizona College of Medicine, Phoenix, Arizona","institution_ids":["https://openalex.org/I4405259572"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":7,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"16","issue":"3","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10516","display_name":"Parathyroid Disorders and Treatments","score":0.9115999937057495,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10516","display_name":"Parathyroid Disorders and Treatments","score":0.9115999937057495,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10975","display_name":"Bone Tumor Diagnosis and Treatments","score":0.06239999830722809,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10071","display_name":"Bone health and osteoporosis research","score":0.0019000000320374966,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/primary-hyperparathyroidism","display_name":"primary hyperparathyroidism","score":1.0},{"id":"https://openalex.org/keywords/parathyroid-adenoma","display_name":"parathyroid adenoma","score":0.9670000076293945},{"id":"https://openalex.org/keywords/pathological-fracture","display_name":"pathological fracture","score":0.9150000214576721},{"id":"https://openalex.org/keywords/distal-femur","display_name":"distal femur","score":0.8690000176429749},{"id":"https://openalex.org/keywords/brown-tumor","display_name":"brown tumor","score":0.847000002861023},{"id":"https://openalex.org/keywords/osteolytic-lesions","display_name":"osteolytic lesions","score":0.8389999866485596},{"id":"https://openalex.org/keywords/adolescents","display_name":"adolescents","score":0.8610000014305115},{"id":"https://openalex.org/keywords/intramedullary-nail","display_name":"intramedullary nail","score":0.765999972820282},{"id":"https://openalex.org/keywords/osteotomy","display_name":"osteotomy","score":0.7850000262260437},{"id":"https://openalex.org/keywords/bone-biopsy","display_name":"bone biopsy","score":0.6290000081062317}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9585000276565552},{"id":"https://openalex.org/C92162645","wikidata":"https://www.wikidata.org/wiki/Q655955","display_name":"Intramedullary rod","level":2,"score":0.777400016784668},{"id":"https://openalex.org/C2779053571","wikidata":"https://www.wikidata.org/wiki/Q2919083","display_name":"Primary hyperparathyroidism","level":2,"score":0.7289999723434448},{"id":"https://openalex.org/C2778195839","wikidata":"https://www.wikidata.org/wiki/Q1753467","display_name":"Pathologic fracture","level":2,"score":0.5906000137329102},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.5748999714851379},{"id":"https://openalex.org/C2781156865","wikidata":"https://www.wikidata.org/wiki/Q827023","display_name":"Lesion","level":2,"score":0.5418000221252441},{"id":"https://openalex.org/C2780554211","wikidata":"https://www.wikidata.org/wiki/Q176503","display_name":"Femur","level":2,"score":0.4997999966144562},{"id":"https://openalex.org/C2780012534","wikidata":"https://www.wikidata.org/wiki/Q4350503","display_name":"Femoral fracture","level":3,"score":0.4657000005245209},{"id":"https://openalex.org/C2775945674","wikidata":"https://www.wikidata.org/wiki/Q1344835","display_name":"Hyperparathyroidism","level":2,"score":0.44780001044273376},{"id":"https://openalex.org/C2780154810","wikidata":"https://www.wikidata.org/wiki/Q4976425","display_name":"Brown tumor","level":5,"score":0.4246000051498413},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.4189999997615814},{"id":"https://openalex.org/C2777736040","wikidata":"https://www.wikidata.org/wiki/Q799615","display_name":"Osteitis fibrosa cystica","level":3,"score":0.3912999927997589},{"id":"https://openalex.org/C2992660301","wikidata":"https://www.wikidata.org/wiki/Q4350503","display_name":"Femur fracture","level":3,"score":0.32760000228881836},{"id":"https://openalex.org/C2778838027","wikidata":"https://www.wikidata.org/wiki/Q3622611","display_name":"Secondary hyperparathyroidism","level":4,"score":0.3172000050544739},{"id":"https://openalex.org/C2776169692","wikidata":"https://www.wikidata.org/wiki/Q4941552","display_name":"Bone disease","level":3,"score":0.3156000077724457},{"id":"https://openalex.org/C195121873","wikidata":"https://www.wikidata.org/wiki/Q1131385","display_name":"Medullary cavity","level":2,"score":0.30709999799728394},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.2996000051498413},{"id":"https://openalex.org/C2776389721","wikidata":"https://www.wikidata.org/wiki/Q2167748","display_name":"Osteotomy","level":2,"score":0.29440000653266907},{"id":"https://openalex.org/C2779561271","wikidata":"https://www.wikidata.org/wiki/Q7243102","display_name":"Primary bone","level":2,"score":0.28279998898506165},{"id":"https://openalex.org/C68312169","wikidata":"https://www.wikidata.org/wiki/Q216685","display_name":"Orthopedic surgery","level":2,"score":0.2630999982357025},{"id":"https://openalex.org/C190892606","wikidata":"https://www.wikidata.org/wiki/Q3512464","display_name":"Radiological weapon","level":2,"score":0.25589999556541443},{"id":"https://openalex.org/C2780551157","wikidata":"https://www.wikidata.org/wiki/Q938983","display_name":"Osteomyelitis","level":2,"score":0.25220000743865967},{"id":"https://openalex.org/C2781343496","wikidata":"https://www.wikidata.org/wiki/Q1178507","display_name":"Osteitis","level":3,"score":0.25029999017715454}],"mesh":[{"descriptor_ui":"D000092524","descriptor_name":"Femoral Fractures, Distal","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005264","descriptor_name":"Femoral Fractures","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":true},{"descriptor_ui":"D005598","descriptor_name":"Fractures, Spontaneous","qualifier_ui":"Q000000981","qualifier_name":"diagnostic imaging","is_major_topic":true},{"descriptor_ui":"D005598","descriptor_name":"Fractures, Spontaneous","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":true},{"descriptor_ui":"D005598","descriptor_name":"Fractures, Spontaneous","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010282","descriptor_name":"Parathyroid Neoplasms","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D010282","descriptor_name":"Parathyroid Neoplasms","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D049950","descriptor_name":"Hyperparathyroidism, Primary","qualifier_ui":"Q000000981","qualifier_name":"diagnostic imaging","is_major_topic":true},{"descriptor_ui":"D049950","descriptor_name":"Hyperparathyroidism, Primary","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D049950","descriptor_name":"Hyperparathyroidism, Primary","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.2106/jbjs.cc.26.00240","doi":"https://doi.org/10.2106/jbjs.cc.26.00240","is_oa":false,"landing_page_url":"https://doi.org/10.2106/jbjs.cc.26.00240","pdf_url":null,"source":{"id":"https://openalex.org/S4210176812","display_name":"JBJS Case Connector","issn_l":"2160-3251","issn":["2160-3251"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline","norway-1","poland-20","russia-white-list-4"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JBJS Case Connector","raw_type":"journal-article"},{"id":"pmid:42809647","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42809647","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JBJS case connector","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.98580002784729}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":24,"referenced_works":["https://openalex.org/W68836595","https://openalex.org/W192763881","https://openalex.org/W1966963227","https://openalex.org/W1978073382","https://openalex.org/W1995399136","https://openalex.org/W2053742178","https://openalex.org/W2056878417","https://openalex.org/W2083335520","https://openalex.org/W2134934447","https://openalex.org/W2162648693","https://openalex.org/W2163455253","https://openalex.org/W2222536184","https://openalex.org/W2472842554","https://openalex.org/W2533128034","https://openalex.org/W2736526524","https://openalex.org/W2754951512","https://openalex.org/W3193943527","https://openalex.org/W3206083345","https://openalex.org/W4211249087","https://openalex.org/W4245825074","https://openalex.org/W4245973601","https://openalex.org/W4307208491","https://openalex.org/W7125949992","https://openalex.org/W7128796330"],"related_works":["https://openalex.org/W3123691651","https://openalex.org/W4412057183","https://openalex.org/W4367847157","https://openalex.org/W4366083628","https://openalex.org/W2271350297","https://openalex.org/W1989715714","https://openalex.org/W2998977993","https://openalex.org/W4366313402","https://openalex.org/W2068335951","https://openalex.org/W2095769106"],"abstract_inverted_index":{"CASE:":[0],"A":[1],"17-year-old":[2],"adolescent":[3],"boy":[4],"presented":[5],"with":[6,28,58,71],"a":[7,33,83],"pathologic":[8,77],"distal":[9,14,23],"femur":[10],"fracture":[11],"and":[12,42,61],"bilateral":[13,22],"femoral":[15,24],"metadiaphyseal":[16,54],"lytic":[17,80],"lesions.":[18],"Multidisciplinary":[19],"evaluation":[20],"confirmed":[21],"brown":[25],"tumors":[26],"associated":[27],"primary":[29],"hyperparathyroidism":[30,67],"secondary":[31],"to":[32],"parathyroid":[34],"adenoma.":[35],"Treatment":[36],"included":[37],"bone":[38],"biopsy,":[39],"curettage,":[40],"grafting,":[41],"retrograde":[43],"locked":[44],"intramedullary":[45,63],"nail,":[46],"followed":[47],"by":[48],"definitive":[49],"partial":[50],"parathyroidectomy.":[51],"The":[52],"contralateral":[53],"lesion":[55],"was":[56],"treated":[57],"corrective":[59],"osteotomy":[60],"prophylactic":[62,97],"stabilization.":[64],"CONCLUSION:":[65],"Primary":[66],"may":[68],"initially":[69],"present":[70],"symptomatic":[72],"skeletal":[73,95],"manifestations":[74],"and,":[75],"rarely,":[76],"fracture.":[78,104],"Multifocal":[79],"lesions":[81],"are":[82],"diagnostic":[84],"red":[85],"flag":[86],"which":[87],"should":[88],"prompt":[89],"early":[90],"biochemical":[91],"evaluation.":[92],"In":[93],"advanced":[94],"involvement,":[96],"stabilization":[98],"can":[99],"reduce":[100],"risk":[101],"of":[102],"subsequent":[103]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-10-01T00:00:00"}