<prompt> A 28-year-old lady presented with nausea, vomiting and abdominal pain. X-Ray was done which showed centrally located lytic lesions in metacarpals as shown. Next line of management will be:Bone curettage with bone graftingExtended curettage with phenolExtended curettage with bone graftingParathyroid hormone and serum calcium levels measurement  <response>: Above x ray depicts- Classical and pathognomic feature of hyperparathyroidism is subperiosteal coical resorption of middle phalanges on radial aspect. Dont confuse it with enchondroma because middle age and female gender point it more towards hyperparathyroidism. Parathyroid hormone and serum calcium levels measurement is required to confirm the diagnosis. 