Ms. Cui, 39, has been experiencing bilateral knee and hip pain for some time now, which is more severe at night. At first, she thought it was caused by excessive physical work during the day, but after resting for a while, the pain did not ease, but continued to worsen. Later, I heard that the pain might be due to calcium deficiency, so I bought a bunch of calcium supplements and ate them, but instead of relieving the pain, it became more and more severe, so that I could not take care of household chores. I had no choice but to go to the orthopedic department of the hospital, and found that there was severe osteoporosis in many parts of the body and also double kidney stones. And the blood calcium is much higher than normal people. Why can’t the calcium eaten get into the bones but form stones? The orthopedic surgeon immediately thought of a disease that was becoming more and more common. The endocrinologist was consulted and found that hyperparathyroidism (hereinafter referred to as “hyperparathyroidism”) was suspected. Since hyperparathyroidism can be cured by surgery, the surgeon performed a major parathyroidectomy, after which Ms. Cui’s joint pain was significantly reduced and her osteoporosis improved, and she was happily discharged from the hospital. In fact, bone pain, fractures and urinary stones are common conditions that plague people’s lives, and one of the important causes of these lesions is hyperparathyroidism. Misdiagnosis and mistreatment due to insufficient knowledge of hyperparathyroidism are common, which not only wastes patients’ energy and financial resources and seriously affects their quality of life, but also can lead to irreversible organ damage and even death. This group of patients are like Ms. Cui, who initially presented with skeletal lesions or recurrent kidney stones, but later discovered that the culprit was hyperparathyroidism. People with the following manifestations should be actively screened for this condition. 1. unexplained generalized aches and pains, fatigue and weakness or joint pain; 2. recurrent urinary stones; 3. unexplained abnormal mental activity, such as indifference or irritability, especially with polyuria; 4. unexplained constipation, poor appetite, abdominal distension and pain, or recurrent peptic ulcers or pancreatitis; 5. long-term renal dysfunction; 6. elevated blood calcium; 7. significantly lower bone density than people of the same sex and age; 8. Those who have a history of thyroid, adrenal or pituitary gland tumors. The incidence of hyperparathyroidism increases with age, so it is more common in middle-aged and elderly people. The diagnosis of hyperparathyroidism is made in combination with blood sampling for hormone levels and imaging tests such as ultrasound. Surgery is the only effective means of treating the disease. When it comes to surgery, many patients and families worry about all the risks associated with surgery. It is true that, as with any surgery, parathyroid surgery has potential risks, but they can be minimized in the hands of an experienced thyroid surgeon. The surgery can be performed using a minimally invasive approach to remove the diseased parathyroid gland, requiring only a small incision (usually 3 cm) to safely complete the surgery, which takes about 40 minutes and results in minimal bleeding (usually less than 10 ml). You can speak, eat, and move around normally on the day of surgery. The vast majority of primary hyperparathyroidism can be cured radically, and the earlier the treatment, the more complete the recovery. Myalgias and psychiatric symptoms mostly disappear after successful surgery, and osteoporosis improves, but recovery from renal impairment or fibrous cystic osteitis that has already occurred is difficult. The biggest problem with surgery is that there is a certain rate of recurrence after surgery, but even if recurrence occurs, it can be treated by surgery again. As a result, we should not be satisfied with “calcium supplementation” for osteoporosis, but also rule out the possibility of hyperparathyroidism. Once detected, early surgical treatment by an experienced physician can provide a satisfactory outcome.