Abstract：
BACKGROUND: Primary hyperparathyroidism (PHPT) should be considered in the differential diagnosis of a patient with suspected secondary osteoporosis, and severe osteoporosis with multiple fractures is frequently the first clinical manifestation of the disease.
METHODS: Mutilating arthritis (arthritis mutilans) can be part of the clinical presentation of a number of rheumatic diseases, most commonly seen in psoriatic arthritis, rheumatoid arthritis, and juvenile idiopathic arthritis, but also in systemic lupus, systemic sclerosis, and multicentric reticulohistiocytosis. Evidence exists that subperiosteal and subchondral bone resorption, seen in PHPT, could induce the so-called \'osteogenic synovitis\', which could eventually lead to the development of a secondary osteoarthritis with bone deformities.
CONCLUSIONS: Here, we present a case report of a patient initially diagnosed with PHPT who presented with mutilating arthritis of the finger joints and discuss whether the severe acro-osteolysis is a manifestation of the endocrinopathy or whether there is a co-existing undiagnosed inflammatory joint disease.
METHODS: Mutilating arthritis (arthritis mutilans) can be part of the clinical presentation of a number of rheumatic diseases, most commonly seen in psoriatic arthritis, rheumatoid arthritis, and juvenile idiopathic arthritis, but also in systemic lupus, systemic sclerosis, and multicentric reticulohistiocytosis. Evidence exists that subperiosteal and subchondral bone resorption, seen in PHPT, could induce the so-called \'osteogenic synovitis\', which could eventually lead to the development of a secondary osteoarthritis with bone deformities.
CONCLUSIONS: Here, we present a case report of a patient initially diagnosed with PHPT who presented with mutilating arthritis of the finger joints and discuss whether the severe acro-osteolysis is a manifestation of the endocrinopathy or whether there is a co-existing undiagnosed inflammatory joint disease.
摘要：
背景：原发性甲状旁腺功能亢进（PHPT）在鉴别诊断怀疑继发性骨质疏松症的患者时应考虑，严重的骨质疏松伴多发性骨折通常是该病的第一临床表现。
方法：多发性关节炎可能是许多风湿性疾病临床表现的一部分，最常见于银屑病关节炎,类风湿性关节炎,和幼年特发性关节炎，而且在系统性狼疮中，系统性硬化症,和多中心网状组织细胞增生症。有证据表明骨膜下和软骨下骨吸收，在PHPT中看到，可以诱发所谓的“成骨滑膜炎”，最终可能导致继发性骨性关节炎伴骨畸形的发展。
结论：这里，我们提供了一例最初诊断为PHPT的患者的病例报告,该患者表现为手指关节的肢解性关节炎,并讨论严重的关节骨溶解是否为内分泌病的表现,或者是否同时存在未确诊的炎症性关节病.
方法：多发性关节炎可能是许多风湿性疾病临床表现的一部分，最常见于银屑病关节炎,类风湿性关节炎,和幼年特发性关节炎，而且在系统性狼疮中，系统性硬化症,和多中心网状组织细胞增生症。有证据表明骨膜下和软骨下骨吸收，在PHPT中看到，可以诱发所谓的“成骨滑膜炎”，最终可能导致继发性骨性关节炎伴骨畸形的发展。
结论：这里，我们提供了一例最初诊断为PHPT的患者的病例报告,该患者表现为手指关节的肢解性关节炎,并讨论严重的关节骨溶解是否为内分泌病的表现,或者是否同时存在未确诊的炎症性关节病.
