For most men, the 30s is the time to be physically tough and fit. However, the nearly confused Mr. Zhong, but has been suffering from pain for many years, from lumbar spine surgery to multiple fractures throughout the body reset, Mr. Zhong has been under the knife enough to surprise ordinary people! Since this year, Mr. Zhong’s back and leg pain is more frequent attacks, even walking need to be supported by family members, let alone go out to work. The old man and the young man, as the breadwinner of his collapse, the original not rich family added to the woes. The family is anxious, Mr. Zhong also tossed around a number of hospitals to seek medical advice, painkillers to eat a lot, but the “headache, foot pain” method can only treat the symptoms, can not eradicate the lesion. After a few weeks, Mr. Zhong came to Guangdong Provincial People’s Hospital with a glimmer of hope. The patient’s recurring spontaneous rib fractures caused the experts to pay great attention. How could a man in the prime of life develop such a serious bone decalcification lesion? After a joint consultation among orthopedic, rheumatology, and otorhinolaryngology-head and neck surgery specialists, the patient’s elevated blood calcium, decreased blood phosphorus, abnormally high parathyroid hormone, and generalized osteoporosis pointed to the possibility of primary hyperparathyroidism. Subsequently, further radionuclide tests revealed the real “culprit” – a right inferior parathyroid adenoma. After excluding the ectopic parathyroid glands on chest CT, the “right inferior parathyroidectomy” was performed as scheduled. After the operation, the pathology confirmed the preoperative assumptions, and all the abnormal laboratory parameters of the patient returned to normal. A week later, the bone pain that had plagued him for many years was relieved, and Mr. Zhong was discharged from the hospital with a happy heart, his light footsteps saying goodbye to his previous hobbling steps. Over the years, medical science has gradually entered the hearts of the people, the people pay close attention to their health, and their understanding of some diseases has greatly improved. However, the term “primary hyperparathyroidism” in Mr. Zhong’s case is not only unfamiliar to the general public, but also easily misdiagnosed clinically. According to Chen Liangzi, deputy director of the Department of Otolaryngology, Head and Neck Surgery, primary hyperparathyroidism is a disease of the parathyroid glands themselves, resulting in the synthesis and secretion of excessive parathyroid hormone, causing skeletal, renal, digestive and neurological lesions and disorders of calcium and phosphorus metabolism. Because of its lack of characteristic manifestations, it is easily misdiagnosed clinically. In recent years, the disease has been on the rise and is second only to diabetes mellitus and hyperthyroidism in terms of endocrine diseases. Primary hyperparathyroidism can be clinically classified into three types: bone type, kidney type, and kidney-bone type. Bone type: The main complaints are low back pain and generalized bone and joint pain, mainly manifesting as bone decalcification, osteoporosis and pathological fracture in severe cases, which can be easily misdiagnosed as rheumatoid arthritis, lumbar strain and lumbar disc herniation. Renal type: often with renal colic and hematuria as the main complaints, easily misdiagnosed as urinary stones. Renal bone type: both of the above. There are also a few patients with gastrointestinal symptoms as the main complaint, which are often misdiagnosed as acute gastroenteritis or peptic ulcer. The good news is that in most patients, the cause of the primary hyperparathyroidism is a single benign monoclonal adenoma, which is benign in 90% of cases. Once diagnosed, surgery should be performed as soon as possible, as it has an immediate effect. Post-operative calcium supplementation is necessary to consolidate the results. Experts suggest that the following manifestations should be considered as possible primary hyperparathyroidism and should not be taken lightly: low back pain, generalized bone and joint pain unrelated to climate change and ineffective anti-rheumatic treatment; recurrent urinary stones and pyelonephritis, especially bilateral simultaneous onset; recurrent acute gastroenteritis, chronic pancreatitis and intractable constipation, etc., for which conventional treatment is ineffective.