A 45-year-old woman presented with a 3-month history of generalized body pains that did not recede after analgesic consumption. Along with low back pain, she had difficulty in getting up from sitting and supine positions and in walking. There was no history of trauma or any medicines. The patient always wears black veils outdoors and is completely covered, with little exposure to sun.
Examination She had a waddling gait with painful movements of both thighs. Serum Calcium level was 8.4mg/dl (reference range: 8.0 -10.4 mg/Dl) Phosphate level 1.5mg/dl (reference range: 2.5 -4.5 mg/Dl) Alkaline phosphatase level 916 U/liter (reference range: 30-120 U/liter) 25-hydroxyvitamin D level 9 nmol/liter (reference range, 18 to 100) Radiograph of pelvis indicated an un-displaced transverse fracture of the shaft of both femurs (first image). The patient was treated with therapeutic doses of Calcium…
