Born via vaginal delivery at 23 weeks + 6 days' gestation (very early premature). Among the abundance of problems associated with early prematurity, he was diagnosed with osteopenia of prematurity. Hyperparathyroidism was discovered. Received treatment which included a supplement of calcium, phosphorus, vitamin D and alpha-D3, as well as bicarbonate. All values gradually normalized, after which bicarbonate and alpha-D3 were discontinued.

Renal ultrasound (not shown), repeated several times during the infant's prolonged stay at the NICU, did not show nephrocalcinosis.

This case demonstrates a transient state of "bone within a bone" after commencing treatment for secondary hyperparathyroidism.