An X-ray image of the left-hand shows thin bones with brown tumors and osteolysis of the distal phalanges

A 50-year-old woman is brought to the office by her daughter with a chief complaint of finger pain in her left hand. She is slightly confused and can’t remember when the pain started. Her daughter states that the pain has been present for approximately one month. She expresses concern that her mother has been progressively more confused during the past week. She reports that her mother also has had worsening nausea for several months. The patient’s vital signs are heart rate 92/min, respiratory rate 13/min, temperature 37.1°C (98.8°F), and blood pressure 120/86 mm Hg. Upon physical examination, the patient reports pain when the fingers of the left hand are palpated, and small palpable tumors are visible on the fingers. An X-ray image of the left-hand shows thin bones with brown tumors and osteolysis of the distal phalanges. What is the most likely cause for this patient’s condition?

A. Hyperparathyroidism
B. Hypocalcemia
C. Osteosarcoma
D. Multiple myeloma
E. Osteoporosis

hyperparathyroidism = stones, bones, groans and psychiatric undertones. Hyperparathyroidism causes hypercalcemia due to increased bone resorption. I don’t remember the exact pathogenesis, but the body compensates by depositing a brown like substance into the bone space that has been depeleted. this explains her arthritic like symptoms. Hypercalcemia causes GI sx (usually constipation) and pseudo depression, which explains her nausea and confusion.