{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:14:07Z","timestamp":1783660447860,"version":"3.55.0"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Primary hyperparathyroidism, though commonly diagnosed through hypercalcemic symptoms, can rarely present as advanced skeletal pathology due to delayed recognition. Metabolic bone disease, including osteitis fibrosa cystica and fragility fractures, represents a late and uncommon manifestation in the modern diagnostic era.\n\nCase Report: We report a rare case of a 26-year-old male who presented with bilateral femoral neck fractures following 4.5 years of progressive hip pain. He had a history of parathyroid adenoma excision 2 years prior and was diagnosed with \u201chungry bone syndrome\u201d postoperatively. Imaging revealed classic skeletal changes of severe metabolic bone disease, including osteolysis, spinal deformities, and multiple cystic lesions. He underwent staged bilateral total hip arthroplasty with good functional recovery over 1 year.\n\nConclusion: This case underscores the importance of considering primary hyperparathyroidism in young patients presenting with unexplained skeletal complaints. Early recognition and management are essential to prevent irreversible bone damage and avoid debilitating complications such as bilateral femoral neck fractures.\n\nKeywords: Primary hyperparathyroidism, parathyroid adenoma, metabolic bone disease, bilateral femoral neck fracture, hungry bone syndrome, total hip arthroplasty.<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i07.7678","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:30:56Z","timestamp":1783657856000},"page":"320-324","source":"Crossref","is-referenced-by-count":0,"title":["The Development of Metabolic Bone Failure as the Principal Manifestation of Undiagnosed Primary Hyperparathyroidism: A Rare Instance of Bilateral Femoral Neck Fractures"],"prefix":"10.13107","volume":"16","author":[{"given":"M Sharath","family":"Raj","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aduri Tharun","family":"Teja","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V B","family":"Shrinivas","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souvik","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Livasa Hospital, Mohali, Punjab, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:31:33Z","timestamp":1783657893000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/07\/the-development-of-metabolic-bone-failure-as-the-principal-manifestation-of-undiagnosed-primary-hyperparathyroidism-a-rare-instance-of-bilateral-femoral-neck-fractures\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i07.7678","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}