A 55 year old woman came with the complaints of right flank pain and increased frequency of micturition since four months
The lateral radiograph of the skull shows multiple tiny lucent areas alternating with similar areas of sclerosis in the skull vault giving rise to the "salt and pepper skull" appearance. The radiograph of the hand shows osteoporosis with coarse trabeculations of the phalanges with subperiosteal resorption along the radial aspects. The radiograph of both the legs shows decreased bone density with few well defined lytic areas in the cortex.