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<title>[Box], Clinical Case 5.7 - Endocrinology - NCBI Bookshelf</title>
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<meta name="robots" content="NOINDEX,NOFOLLOW,NOARCHIVE,NOIMAGEINDEX" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="[Box], Clinical Case 5.7" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="BIOS Scientific Publishers" /><meta name="DC.Contributor" content="Stephen Nussey" /><meta name="DC.Contributor" content="Saffron Whitehead" /><meta name="DC.Date" content="2001" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK24/" /><meta name="description" content="A 78-year-old widow presented to the Rheumatology clinic with a several year history of deformity and discomfort in the lower right leg (Box 5.37). Her serum Ca2+ was 2.76 mmol/l (NR 2.2–2.6 mmol/l) with a Pi of 1.03 mmol/l (NR 0.8–1.4 mmol/l) and an alkaline phosphatase of 335 IU/l (NR 30–100 IU/l). She was treated with an oral bisphosphonate. Nine years later she tripped on a pavement fracturing her right tibia (Box 5.37). At that time the serum Ca2+ was 2.57 mmol/l with a Pi of 1.00 mmol/l and an alkaline phosphatase of 684 IU/l. She was treated with a plaster of Paris cast and the fracture healed over the subsequent 6 months. Seventeen years after presentation, she complained of deteriorating hearing and was referred to the audiology department. At the age of 95 years her serum Ca2+ was 2.42 mmol/l with a Pi of 0.92 mmol/l and an alkaline phosphatase of 513 IU/l." /><meta name="bk-non-canon-loc" content="/books/n/endocrin/A742/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK24/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
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<div class="main-content lit-style"><div class="body-content whole_rhythm"><div id="ch5cc7" class="box"><h3><span class="title">Clinical Case 5.7</span></h3><p>A 78-year-old widow presented to the Rheumatology clinic with a several year history of deformity and discomfort in the lower right leg (Box 5.37). Her serum Ca<sup>2+</sup> was 2.76 mmol/l (NR 2.2–2.6 mmol/l) with a P<sub>i</sub> of 1.03 mmol/l (NR 0.8–1.4 mmol/l) and an alkaline phosphatase of 335 IU/l (NR 30–100 IU/l). She was treated with an oral bisphosphonate. Nine years later she tripped on a pavement fracturing her right tibia (Box 5.37). At that time the serum Ca<sup>2+</sup> was 2.57 mmol/l with a P<sub>i</sub> of 1.00 mmol/l and an alkaline phosphatase of 684 IU/l. She was treated with a plaster of Paris cast and the fracture healed over the subsequent 6 months. Seventeen years after presentation, she complained of deteriorating hearing and was referred to the audiology department. At the age of 95 years her serum Ca<sup>2+</sup> was 2.42 mmol/l with a P<sub>i</sub> of 0.92 mmol/l and an alkaline phosphatase of 513 IU/l.</p></div><div id="bk_toc_contnr"></div></div></div>
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<div class="post-content"><div><p>From: <a href="/books/NBK24/" target="mainwindow">Chapter 5, The parathyroid glands and vitamin D</a></p><div class="iconblock clearfix ten_col"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/endocrin/" target="mainwindow"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-endocrin-lrg.png" alt="Cover of Endocrinology" height="100px" width="80px" /></a><div class="icnblk_cntnt"><div><div>Endocrinology: An Integrated Approach.</div><div>Nussey S, Whitehead S.</div><div>Oxford: <a href="http://www.garlandscience.com/about.asp" target="mainwindow" ref="pagearea=content-footer&targetsite=external&targetcat=link&targettype=publisher">BIOS Scientific Publishers</a>; 2001.</div></div></div></div><div class="half_rhythm"><a href="/books/about/copyright/" target="mainwindow">Copyright</a> © 2001, BIOS Scientific Publishers Limited.</div><p>NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div></div>
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