Rheumatic symptoms in primary hyperparathyroidism.

In a retrospective survey of 34 patients with primary hyperparathyroidism (HPT), 18 (53%0 complained of musculo-skeletal symptoms during the 12 months before the diagnosis was made and 9 (26%) attended at some time for either a rheumatological or orthopaedic consultation. Myalgia was the most frequently reported symptom which occurred in 41% of patients. Arthralgia, mainly affecting the large joints was present in 11 (32%) patients, 2 of whom had an erosive synovitis mimicking rheumatoid arthritis. Radiological abnormalities were seen in 8 patients. Clinicians should be aware of the variety and frequency of musculo-skeletal symptoms associated with HPT and should consider including serum calcium measurements when investigating rheumatic complaints.