This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Metabolic disorders - 1, Subject name: Orthopaedics
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: 
Select and explain. 
A. Bone curettage with bone grafting, B. Extended curettage with phenol, C. Extended curettage with bone grafting, D. Parathyroid hormone and serum calcium levels measurement
D: Parathyroid hormone and serum calcium levels measurement
Answer: D: Parathyroid hormone and serum calcium levels measurement 
Explanation: Above x ray depicts- Classical and pathognomic feature of hyperparathyroidism is subperiosteal coical resorption of middle phalanges on radial aspect. Don't 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.