Paraparesis due to massive ectopic paravertebral calcification in a patient on maintenance hemodialysis

Secondary hyperparathyroidism is ubiquitous in patients with end-stage renal disease who are on dialysis. We report a dialysis patient with an unusual manifestation of hyperparathyroidism. Initially, the patient was misdiagnosed to have clavicular osteomyelitis. The underlying hyperparathyroidism was not recognized, only to be discovered later, when the patient presented with spastic paraplegia and massive ectopic calcification in the cervical spine. The patient made a complete recovery following surgical resection and parathyroidectomy.