Transient painful osteolysis -- a metabolic study

A 45-year-old woman developed severe pain in both knees, attributable to subchondral osteolysis of the femoral condyles. A metabolic investigaexcretion disclosed a marked increase in urinary excretion of calcium, hydroxyproline and fluoride. There was an accompanying elevation of erythrocyte sedimentation rate and peripheral eosinophilia. At the height of fluoride tion, fluoride renal clearance was reduced over values determined later when the fluoride excretion was diminished. We speculate that there may have been circulating microcrystals of hydroxyapatite to explain these differences of renal clearance.