We have treated the following typical patients: an elderly female patient with 10 broken ribs and osteoporosis, who lost weight and height in recent years and achieved “reverse growth”; a middle-aged female patient with recurrent urinary stones, who repeatedly underwent transurethral ureteral laser lithotripsy in the urology department of a local hospital in Jiangsu Province, but her kidney stones still recurred out of nowhere and she became a real “stone man”; a patient with thyroid nodules found during a medical checkup, who became a real “stone man” when she was re-examined. A middle-aged female patient with recurrent urinary stones had undergone repeated transurethral ureteral laser lithotripsy in the urology department of a local hospital in Jiangsu province, but the kidney stones still recurred out of nothing and she became a real “stone man”; a patient with thyroid nodules found during a physical examination visited our outpatient clinic and was found to have an abnormal occupancy of the thyroid adnexa by ultrasound of the neck. The patient also had pain in both shoulder joints, iliopsoas and knee joints, weakness and constipation, and small stones were found in the urinary ultrasound. It was hard to imagine that such a variety of symptoms (osteoporosis, arthralgia, fracture, urinary stones, constipation, and weakness) could be caused by a small parathyroid gland in the neck and throat. Figure 1. Surgical specimens of two patients with hyperparathyroidism, both with pathology of parathyroid adenoma. This is the enlarged parathyroid gland in this picture, which is only 2-3 cm in length, but is causing all the clinical symptoms. The size of the parathyroid glands is measured in millimeters, and the weight is measured in milligrams. The function of the hormone secreted (parathyroid hormone) is to regulate calcium metabolism and maintain blood calcium balance, mainly by releasing bone calcium into and out of the bloodstream and then excreted by the kidneys to regulate blood calcium balance. The target organs of the parathyroid glands are bone and kidney. When hyperfunctioning, it causes excessive bone resorption, making osteoporosis occur earlier, faster and more serious, and basically all have different degrees of bone pain symptoms. Prolonged osteoporosis can also lead to fibrous osteitis, which often leads to shortening of the body and deformity of the limbs, and fractures can occur during light exercise or collisions. Surgery on the parathyroid gland requires surgical positioning, keeping the neck in the hyperextended position. Individual patients with severe osteoporosis admitted to our department often require careful care when placing them in the position, and the amplitude should not be too large. Due to high blood calcium, patients often complain of polyuria, thirst and excessive drinking, and have a high incidence of urinary stones. Urinary calculi are characterized by multiple, recurrent and bilateral attacks, and the stones often increase in size and activity. Hypercalcemia also causes muscle relaxation and hypertonia in the extremities, making the patient easily fatigued and weak. For the digestive system there are symptoms such as lack of appetite, constipation, abdominal distension, nausea and vomiting. Very rarely, even pancreatic calcium salt deposits block the pancreatic duct and pancreatitis occurs. Most of the hyperparathyroidism encountered clinically is parathyroid adenoma, and this has been true for more than 20 patients operated in our department, with the exception of one patient with parathyroid cancer. After the diagnosis of hyperparathyroidism is confirmed, preoperative localization of the diseased gland is performed whenever possible. The hyperparathyroid glands were removed during surgery on the basis of imaging, and parathyroid hormones dropped significantly 10 minutes after surgery. In summary, patients with hyperparathyroidism are inconsistent in their presentation. By the time surgery is diagnosed, some patients have already undergone a long period of “symptomatic treatment”, but their condition is delayed because the real culprit cannot be traced. In patients with hypercalcemia, bone pain, and urinary stones, it is important to keep in mind the small dot – the parathyroid gland.