A 15 year old male Arun Suresh Kammar patient presented with the chief complaints of right elbow swelling with discharging sinus since 5 years. Left elbow swelling and ulcer over left gluteal region since 3 years. Patient noticed gradually progressive, painless swelling over right elbow 5 years back and left gluteal region 3 years back for which he underwent surgery 4 and 3 years back respectively. One year latter patient developed gradually progressive diffuse swelling at left elbow with painful left elbow joint movement. Blood investigations were normal except raised phosphorus-6.8mg/dl(N-2.5-4.5mg/dl) and Alkaline phosphatase-52IU/L(N-20-40IU/L).Total excision was done for the left elbow and left gluteal region (periarticular) swelling and right elbow swelling subsided by itself.
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