TM83 #ACR23 @RheumNow 45yo M b/l sacroiliitis, Rx MTX -> ADA -> MTX + Tofa. No improv Low Ca, & Phos, ALP 239. Nml Vit D, High PTH. DEXA: Osteoporosis FGF23 high PET/CT showed soft tissue density in nasal septum, few cortical breaks Dx: oncogenic osteomalacia 2/2 malignancy https://t.co/EOcYNtovBy