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T1 Age 2 13 47-year-old T2 Sex 14 20 female T3 Clinical_event 29 38 presented E1 Clinical_event:T3 T4 Sign_symptom 63 67 pain E2 Sign_symptom:T4 T5 Biological_structure 75 85 chest wall T6 Biological_structure 87 91 back T7 Sign_symptom 136 151 muscle weakness E3 Sign_symptom:T7 T8 Detailed_description 39 62 progressively worsening R1 MODIFY Arg1:T8 Arg2:E2 R2 MODIFY Arg1:T5 Arg2:E2 R3 MODIFY Arg1:T6 Arg2:E2 T9 Biological_structure 97 124 bilateral lower extremities R4 MODIFY Arg1:T9 Arg2:E2 T10 Family_history 157 215 did not have a family history of bone disease or fractures T11 Diagnostic_procedure 217 237 Physical examination E4 Diagnostic_procedure:T11 T12 Lab_value 242 254 unremarkable R5 MODIFY Arg1:T12 Arg2:E4 T13 Detailed_description 255 296 excluding bone and muscular abnormalities R6 MODIFY Arg1:T13 Arg2:E4 T14 Diagnostic_procedure 303 315 scintigraphy E5 Diagnostic_procedure:T14 T15 Biological_structure 298 302 Bone R7 MODIFY Arg1:T15 Arg2:E5 T16 Detailed_description 316 357 using technetium-99m methylenediphosphate R8 MODIFY Arg1:T16 Arg2:E5 T17 Sign_symptom 375 381 uptake E6 Sign_symptom:T17 T18 Biological_structure 389 397 shoulder T19 Biological_structure 399 412 multiple ribs T20 Biological_structure 414 440 thoracic and lumbar spines R9 MODIFY Arg1:T20 Arg2:E6 R10 MODIFY Arg1:T18 Arg2:E6 R11 MODIFY Arg1:T19 Arg2:E6 T21 Biological_structure 442 469 bilateral sacroiliac joints R12 MODIFY Arg1:T21 Arg2:E6 T22 Biological_structure 471 481 left ilium R13 MODIFY Arg1:T22 Arg2:E6 T23 Biological_structure 487 496 left foot R14 MODIFY Arg1:T23 Arg2:E6 T24 Diagnostic_procedure 512 523 radiographs E7 Diagnostic_procedure:T24 T25 Detailed_description 506 511 Plain R15 MODIFY Arg1:T25 Arg2:E7 T26 Disease_disorder 533 545 osteoporosis E8 Disease_disorder:T26 T27 Biological_structure 556 581 thoracic and lumbar spine R16 MODIFY Arg1:T27 Arg2:E8 T28 Sign_symptom 593 604 compression E9 Sign_symptom:T28 T29 Biological_structure 615 629 several spines R17 MODIFY Arg1:T29 Arg2:E9 T30 Diagnostic_procedure 659 685 magnetic resonance imaging E10 Diagnostic_procedure:T30 T31 Diagnostic_procedure 690 709 computed tomography E11 Diagnostic_procedure:T31 T32 Diagnostic_procedure 711 713 CT E12 Diagnostic_procedure:T32 R18 IDENTICAL Arg1:E12 Arg2:E11 T33 Diagnostic_procedure 734 743 bone mass E13 Diagnostic_procedure:T33 T34 Lab_value 724 733 Decreased R19 MODIFY Arg1:T34 Arg2:E13 T35 Biological_structure 765 777 lumbar spine T36 Biological_structure 795 807 femoral neck T37 Biological_structure 829 832 hip T38 Lab_value 779 792 T-score: −3.4 T39 Lab_value 809 822 T-score: −3.1 T40 Lab_value 834 847 T-score: −3.5 R20 MODIFY Arg1:T35 Arg2:T38 R21 MODIFY Arg1:T36 Arg2:T39 R22 MODIFY Arg1:T37 Arg2:T40 R23 MODIFY Arg1:T38 Arg2:E13 R24 MODIFY Arg1:T39 Arg2:E13 R25 MODIFY Arg1:T40 Arg2:E13 T41 Sign_symptom 911 927 hypophosphatemia E14 Sign_symptom:T41 T42 Sign_symptom 929 940 hypokalemia E15 Sign_symptom:T42 T43 Sign_symptom 942 954 hypouricemia E16 Sign_symptom:T43 T44 Diagnostic_procedure 974 977 ALP E17 Diagnostic_procedure:T44 T45 Diagnostic_procedure 979 993 C-telopeptides E18 Diagnostic_procedure:T45 T46 Diagnostic_procedure 998 1006 chloride E19 Diagnostic_procedure:T46 T47 Lab_value 956 964 elevated R26 MODIFY Arg1:T47 Arg2:E17 R27 MODIFY Arg1:T47 Arg2:E18 R28 MODIFY Arg1:T47 Arg2:E19 T48 Diagnostic_procedure 1022 1052 carbon dioxide combining power E20 Diagnostic_procedure:T48 T49 Lab_value 1012 1021 decreased R29 MODIFY Arg1:T49 Arg2:E20 T50 Diagnostic_procedure 1058 1068 urinalysis E21 Diagnostic_procedure:T50 T51 Diagnostic_procedure 1085 1087 pH E22 Diagnostic_procedure:T51 T52 Lab_value 1080 1084 high R30 MODIFY Arg1:T52 Arg2:E22 R31 SUB_PROCEDURE Arg1:E22 Arg2:E21 T53 Diagnostic_procedure 1114 1123 potassium E23 Diagnostic_procedure:T53 T54 Diagnostic_procedure 1148 1164 specific gravity E24 Diagnostic_procedure:T54 T55 Diagnostic_procedure 1166 1174 chlorine E25 Diagnostic_procedure:T55 T56 Diagnostic_procedure 1180 1189 phosphate E26 Diagnostic_procedure:T56 T57 Lab_value 1095 1104 increased R32 MODIFY Arg1:T57 Arg2:E23 T58 Lab_value 1129 1138 decreased R33 MODIFY Arg1:T58 Arg2:E24 R34 MODIFY Arg1:T58 Arg2:E25 R35 MODIFY Arg1:T58 Arg2:E26 R36 SUB_PROCEDURE Arg1:E23 Arg2:E21 R37 SUB_PROCEDURE Arg1:E24 Arg2:E21 R38 SUB_PROCEDURE Arg1:E25 Arg2:E21 R39 SUB_PROCEDURE Arg1:E26 Arg2:E21 T59 Sign_symptom 1202 1212 glycosuria E27 Sign_symptom:T59 T60 Sign_symptom 1217 1228 proteinuria E28 Sign_symptom:T60 T61 Detailed_description 1191 1201 Persistent R40 MODIFY Arg1:T61 Arg2:E27 T62 Diagnostic_procedure 1267 1272 HbA1c E29 Diagnostic_procedure:T62 T63 Lab_value 1260 1266 normal R41 MODIFY Arg1:T63 Arg2:E29 T64 Diagnostic_procedure 1277 1291 plasma glucose E30 Diagnostic_procedure:T64 R42 MODIFY Arg1:T63 Arg2:E30 T65 Diagnostic_procedure 1305 1320 laboratory test E31 Diagnostic_procedure:T65 T66 Diagnostic_procedure 1339 1355 thyroid function E32 Diagnostic_procedure:T66 T67 Diagnostic_procedure 1362 1387 serum parathyroid hormone E33 Diagnostic_procedure:T67 T68 Diagnostic_procedure 1389 1408 25-hydroxyvitamin D E34 Diagnostic_procedure:T68 T69 Diagnostic_procedure 1414 1437 protein electrophoresis E35 Diagnostic_procedure:T69 T70 Lab_value 1443 1462 within normal range R43 MODIFY Arg1:T70 Arg2:E35 R44 MODIFY Arg1:T70 Arg2:E34 R45 MODIFY Arg1:T70 Arg2:E33 R46 MODIFY Arg1:T70 Arg2:E32 R47 SUB_PROCEDURE Arg1:E32 Arg2:E31 R48 SUB_PROCEDURE Arg1:E33 Arg2:E31 R49 SUB_PROCEDURE Arg1:E34 Arg2:E31 R50 SUB_PROCEDURE Arg1:E35 Arg2:E31 T71 Diagnostic_procedure 1484 1503 serum tumor markers E36 Diagnostic_procedure:T71 T72 Lab_value 1509 1517 negative R51 MODIFY Arg1:T72 Arg2:E36 T73 Diagnostic_procedure 1578 1611 serum fibroblast growth factor 23 E37 Diagnostic_procedure:T73 A1 POLARITY E37 NEG T74 Disease_disorder 1644 1646 HO E38 Disease_disorder:T74 #1 AnnotatorNotes E38 hypophosphatemic osteomalacia T75 Diagnostic_procedure 1696 1715 computed tomography E39 Diagnostic_procedure:T75 T76 Diagnostic_procedure 1648 1695 fluorodeoxyglucose positron emission tomography E40 Diagnostic_procedure:T76 T77 Diagnostic_procedure 1717 1728 18F-FDG PET E41 Diagnostic_procedure:T77 T78 Diagnostic_procedure 1729 1731 CT E42 Diagnostic_procedure:T78 R52 IDENTICAL Arg1:E41 Arg2:E40 R53 IDENTICAL Arg1:E42 Arg2:E39 T79 Diagnostic_procedure 1775 1787 scintigraphy E43 Diagnostic_procedure:T79 T80 Detailed_description 1737 1762 technetium-99m octreotide T81 Detailed_description 1764 1773 99mTc-OCT R54 IDENTICAL Arg1:T81 Arg2:T80 R55 MODIFY Arg1:T80 Arg2:E43 T82 Sign_symptom 1843 1848 tumor E44 Sign_symptom:T82 A2 POLARITY E44 UNCERTAIN T83 Detailed_description 1826 1832 occult T84 Detailed_description 1833 1842 causative R56 MODIFY Arg1:T84 Arg2:E44 R57 MODIFY Arg1:T83 Arg2:E44 T85 Coreference 1880 1893 these 2 tests E45 Coreference:T85 R58 IDENTICAL Arg1:E45 Arg2:E43 R59 IDENTICAL Arg1:E45 Arg2:E40 R60 IDENTICAL Arg1:E45 Arg2:E39 T86 Lab_value 1899 1907 negative R61 MODIFY Arg1:T86 Arg2:E45 T87 Sign_symptom 1925 1931 uptake E46 Sign_symptom:T87 T88 Biological_structure 1939 1950 seventh rib T89 Severity 1920 1924 mild R62 MODIFY Arg1:T89 Arg2:E46 R63 MODIFY Arg1:T88 Arg2:E46 T90 Diagnostic_procedure 1964 1967 PET E47 Diagnostic_procedure:T90 T91 Diagnostic_procedure 1968 1970 CT E48 Diagnostic_procedure:T91 T92 Sign_symptom 2017 2023 lesion E49 Sign_symptom:T92 A3 POLARITY E49 NEG T93 Detailed_description 2006 2016 neoplastic R64 MODIFY Arg1:T93 Arg2:E49 T94 Diagnostic_procedure 2068 2093 immunological examination E50 Diagnostic_procedure:T94 T95 Diagnostic_procedure 2119 2128 serum IgG E51 Diagnostic_procedure:T95 T96 Diagnostic_procedure 2130 2133 IgM E52 Diagnostic_procedure:T96 T97 Diagnostic_procedure 2139 2142 IgA E53 Diagnostic_procedure:T97 R65 SUB_PROCEDURE Arg1:E51 Arg2:E50 R66 SUB_PROCEDURE Arg1:E52 Arg2:E50 R67 SUB_PROCEDURE Arg1:E53 Arg2:E50 T98 Diagnostic_procedure 2164 2184 antinuclear antibody E54 Diagnostic_procedure:T98 T99 Lab_value 2101 2109 elevated R68 MODIFY Arg1:T99 Arg2:E51 R69 MODIFY Arg1:T99 Arg2:E52 R70 MODIFY Arg1:T99 Arg2:E53 T100 Diagnostic_procedure 2186 2203 anti-SSA antibody E55 Diagnostic_procedure:T100 T101 Diagnostic_procedure 2209 2225 rheumatic factor E56 Diagnostic_procedure:T101 T102 Lab_value 2155 2163 positive R71 MODIFY Arg1:T102 Arg2:E54 R72 MODIFY Arg1:T102 Arg2:E55 R73 MODIFY Arg1:T102 Arg2:E56 R74 SUB_PROCEDURE Arg1:E54 Arg2:E50 R75 SUB_PROCEDURE Arg1:E55 Arg2:E50 R76 SUB_PROCEDURE Arg1:E56 Arg2:E50 T103 Diagnostic_procedure 2241 2254 Schirmer test E57 Diagnostic_procedure:T103 T104 Lab_value 2259 2267 abnormal R77 MODIFY Arg1:T104 Arg2:E57 T105 Diagnostic_procedure 2276 2282 biopsy E58 Diagnostic_procedure:T105 T106 Biological_structure 2272 2275 lip R78 MODIFY Arg1:T106 Arg2:E58 T107 Disease_disorder 2310 2312 SS E59 Disease_disorder:T107 #2 AnnotatorNotes E59 Sjogren's syndrome T108 Disease_disorder 2366 2368 HO E60 Disease_disorder:T108 T109 Disease_disorder 2382 2384 SS E61 Disease_disorder:T109 T110 Therapeutic_procedure 2416 2430 alkalinization E62 Therapeutic_procedure:T110 T111 Medication 2432 2439 citrate E63 Medication:T111 T112 Dosage 2440 2447 4 g/day R79 MODIFY Arg1:T112 Arg2:E63 T113 Medication 2452 2469 potassium citrate E64 Medication:T113 T114 Dosage 2470 2477 3 g/day R80 MODIFY Arg1:T114 Arg2:E64 T115 Duration 2482 2489 2 weeks E65 Duration:T115 T116 Medication 2492 2500 steroids E66 Medication:T116 R81 SUB_PROCEDURE Arg1:E63 Arg2:E62 R82 SUB_PROCEDURE Arg1:E64 Arg2:E62 T117 Medication 2502 2512 prednisone E67 Medication:T117 T118 Dosage 2513 2522 20 mg/day T119 Duration 2527 2534 1 month E68 Duration:T119 R83 MODIFY Arg1:T118 Arg2:E67 R84 SUB_PROCEDURE Arg1:E67 Arg2:E66 T120 Dosage 2536 2545 10 mg/day R85 MODIFY Arg1:T120 Arg2:E67 T121 Duration 2550 2558 4 months E69 Duration:T121 R86 MODIFY Arg1:E68 Arg2:T118 R87 MODIFY Arg1:E69 Arg2:T120 R88 MODIFY Arg1:E65 Arg2:T114 T122 Medication 2561 2578 neutral phosphate E70 Medication:T122 T123 Dosage 2580 2589 1.0 g/day R89 MODIFY Arg1:T123 Arg2:E70 T124 Duration 2594 2602 5 months E71 Duration:T124 R90 MODIFY Arg1:E71 Arg2:T123 T125 Medication 2605 2624 calcium supplements E72 Medication:T125 T126 Dosage 2626 2636 600 mg/day R91 MODIFY Arg1:T126 Arg2:E72 T127 Duration 2641 2649 5 months E73 Duration:T127 R92 MODIFY Arg1:E73 Arg2:T126 T128 Medication 2670 2689 activated vitamin D E74 Medication:T128 T129 Dosage 2691 2700 0.5 g/day T130 Duration 2705 2713 5 months E75 Duration:T130 R93 MODIFY Arg1:T129 Arg2:E74 R94 MODIFY Arg1:E75 Arg2:T129 T131 Sign_symptom 2728 2737 recovered E76 Sign_symptom:T131 T132 Sign_symptom 2765 2769 pain E77 Sign_symptom:T132 A4 POLARITY E77 NEG T133 Diagnostic_procedure 2784 2800 serum phosphorus E78 Diagnostic_procedure:T133 T134 Lab_value 2774 2783 increased R95 MODIFY Arg1:T134 Arg2:E78 R96 AFTER Arg1:E1 Arg2:E2 * OVERLAP E2 E3 R97 BEFORE Arg1:E3 Arg2:E4 * OVERLAP E4 E5 E6 E7 E8 E9 E10 E11 E13 E14 E15 E16 E17 E18 E19 E20 E21 E27 E28 E29 E30 E31 E36 E37 R98 BEFORE Arg1:E37 Arg2:E38 * OVERLAP E38 E40 E39 E43 E44 E45 E46 E47 E48 E49 E50 R99 BEFORE Arg1:E50 Arg2:E57 * OVERLAP E57 E58 E59 R100 BEFORE Arg1:E59 Arg2:E60 * OVERLAP E60 E61 E62 E65 E66 E68 E69 E70 E71 E72 E73 E74 E75 R101 BEFORE Arg1:E75 Arg2:E76 * OVERLAP E76 E77 E78