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Hyperparathyroidism
Kirkland W. Davis, MD, FACR; Cheryl A. Petersilge, MD, MBA
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Hyperparathyroidism (HPTH)
            • Parathyroid (PT)
          • Synonyms

            • Advanced skeletal changes
              • von Recklinghausen disease of bone
              • Osteitis fibrosis cystica (includes pain, fragility fractures)
            • Brown tumor: osteoclastoma
          • Definitions

            • Disease resulting from ↑ PT hormone (PTH)
            • Chronic kidney disease-mineral and bone disorder (CKD-MBD): term coined to encompass skeletal changes, hormone disturbances, and cardiovascular complications that can occur in CKD

          IMAGING

          • General Features

            • Imaging Recommendations

              • Radiographic Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Other Modality Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Ferreira AC et al: The role of bone biopsy in the management of CKD-MBD. Calcif Tissue Int. 108(4):528-38, 2021
                                        2. Habas E Sr et al: Secondary hyperparathyroidism in chronic kidney disease: pathophysiology and management. cureus. 13(7):e16388, 2021
                                        3. Islam AK: Advances in the diagnosis and the management of primary hyperparathyroidism. Ther Adv Chronic Dis. 12:20406223211015965, 2021
                                        4. Khalatbari H et al: Pediatric hyperparathyroidism: review and imaging update. Pediatr Radiol. 51(7):1106-20, 2021
                                        5. Bennett J et al: Osseous manifestations of primary hyperparathyroidism: imaging findings. Int J Endocrinol. 2020:3146535, 2020
                                        6. Xie C et al: Imaging of brown tumours: a pictorial review. Insights Imaging. 10(1):75, 2019
                                        7. Bandeira F et al: Bone disease in primary hyperparathyroidism. Arq Bras Endocrinol Metabol. 58(5):553-61, 2014
                                        8. Boswell SB et al: Musculoskeletal manifestations of endocrine disorders. Clin Imaging. 38(4):384-96, 2014
                                        9. Hoang JK et al: How to perform parathyroid 4D CT: tips and traps for technique and interpretation. Radiology. 270(1):15-24, 2014
                                        10. Schwarz P et al: The PRIMARA study: a prospective, descriptive, observational study to review cinacalcet use in patients with primary hyperparathyroidism in clinical practice. Eur J Endocrinol. 171(6):727-35, 2014
                                        11. Hermoye A et al: F-18 FDG PET/CT as a noninvasive diagnostic and follow-up tool in brown tumors due to secondary hyperparathyroidism. Clin Nucl Med. 34(5):330-2, 2009
                                        12. Lacativa PG et al: Prevalence of radiological findings among cases of severe secondary hyperparathyroidism. Sao Paulo Med J. 127(2):71-7, 2009
                                        13. Levine DS et al: Hybrid SPECT/CT imaging for primary hyperparathyroidism: case reports and pictorial review. Clin Nucl Med. 34(11):779-84, 2009
                                        14. Lew JI et al: Surgical management of primary hyperparathyroidism: state of the art. Surg Clin North Am. 89(5):1205-25, 2009
                                        15. Randall GJ et al: Contrast-enhanced MDCT characteristics of parathyroid adenomas. AJR Am J Roentgenol. 193(2):W139-43, 2009
                                        16. Thurley PD et al: Case report: rapidly progressive metastatic pulmonary calcification: evolution of changes on CT. Br J Radiol. 82(980):e155-9, 2009
                                        17. Bhadada SK et al: Characteristics of primary hyperparathyroidism in adolescents. J Pediatr Endocrinol Metab. 21(12):1147-53, 2008
                                        18. Agarwal G et al: Recovery pattern of patients with osteitis fibrosa cystica in primary hyperparathyroidism after successful parathyroidectomy. Surgery. 132(6):1075-83; discussion 1083-5, 2002
                                        19. Singhal S et al: Primary hyperparathyroidism: what every orthopedic surgeon should know. Orthopedics. 24(10):1003-9; quiz 1010-1, 2001
                                        20. Genant HK et al: Primary hyperparathyroidism. A comprehensive study of clinical, biochemical and radiographic manifestations. Radiology. 109(3):513-24, 1973
                                        21. Simpson W et al: Skeletal changes in patients on regular hemodialysis. Radiology. 107(2):313-20, 1973
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Hyperparathyroidism (HPTH)
                                                  • Parathyroid (PT)
                                                • Synonyms

                                                  • Advanced skeletal changes
                                                    • von Recklinghausen disease of bone
                                                    • Osteitis fibrosis cystica (includes pain, fragility fractures)
                                                  • Brown tumor: osteoclastoma
                                                • Definitions

                                                  • Disease resulting from ↑ PT hormone (PTH)
                                                  • Chronic kidney disease-mineral and bone disorder (CKD-MBD): term coined to encompass skeletal changes, hormone disturbances, and cardiovascular complications that can occur in CKD

                                                IMAGING

                                                • General Features

                                                  • Imaging Recommendations

                                                    • Radiographic Findings

                                                      • MR Findings

                                                        • Nuclear Medicine Findings

                                                          • Other Modality Findings

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Ferreira AC et al: The role of bone biopsy in the management of CKD-MBD. Calcif Tissue Int. 108(4):528-38, 2021
                                                                              2. Habas E Sr et al: Secondary hyperparathyroidism in chronic kidney disease: pathophysiology and management. cureus. 13(7):e16388, 2021
                                                                              3. Islam AK: Advances in the diagnosis and the management of primary hyperparathyroidism. Ther Adv Chronic Dis. 12:20406223211015965, 2021
                                                                              4. Khalatbari H et al: Pediatric hyperparathyroidism: review and imaging update. Pediatr Radiol. 51(7):1106-20, 2021
                                                                              5. Bennett J et al: Osseous manifestations of primary hyperparathyroidism: imaging findings. Int J Endocrinol. 2020:3146535, 2020
                                                                              6. Xie C et al: Imaging of brown tumours: a pictorial review. Insights Imaging. 10(1):75, 2019
                                                                              7. Bandeira F et al: Bone disease in primary hyperparathyroidism. Arq Bras Endocrinol Metabol. 58(5):553-61, 2014
                                                                              8. Boswell SB et al: Musculoskeletal manifestations of endocrine disorders. Clin Imaging. 38(4):384-96, 2014
                                                                              9. Hoang JK et al: How to perform parathyroid 4D CT: tips and traps for technique and interpretation. Radiology. 270(1):15-24, 2014
                                                                              10. Schwarz P et al: The PRIMARA study: a prospective, descriptive, observational study to review cinacalcet use in patients with primary hyperparathyroidism in clinical practice. Eur J Endocrinol. 171(6):727-35, 2014
                                                                              11. Hermoye A et al: F-18 FDG PET/CT as a noninvasive diagnostic and follow-up tool in brown tumors due to secondary hyperparathyroidism. Clin Nucl Med. 34(5):330-2, 2009
                                                                              12. Lacativa PG et al: Prevalence of radiological findings among cases of severe secondary hyperparathyroidism. Sao Paulo Med J. 127(2):71-7, 2009
                                                                              13. Levine DS et al: Hybrid SPECT/CT imaging for primary hyperparathyroidism: case reports and pictorial review. Clin Nucl Med. 34(11):779-84, 2009
                                                                              14. Lew JI et al: Surgical management of primary hyperparathyroidism: state of the art. Surg Clin North Am. 89(5):1205-25, 2009
                                                                              15. Randall GJ et al: Contrast-enhanced MDCT characteristics of parathyroid adenomas. AJR Am J Roentgenol. 193(2):W139-43, 2009
                                                                              16. Thurley PD et al: Case report: rapidly progressive metastatic pulmonary calcification: evolution of changes on CT. Br J Radiol. 82(980):e155-9, 2009
                                                                              17. Bhadada SK et al: Characteristics of primary hyperparathyroidism in adolescents. J Pediatr Endocrinol Metab. 21(12):1147-53, 2008
                                                                              18. Agarwal G et al: Recovery pattern of patients with osteitis fibrosa cystica in primary hyperparathyroidism after successful parathyroidectomy. Surgery. 132(6):1075-83; discussion 1083-5, 2002
                                                                              19. Singhal S et al: Primary hyperparathyroidism: what every orthopedic surgeon should know. Orthopedics. 24(10):1003-9; quiz 1010-1, 2001
                                                                              20. Genant HK et al: Primary hyperparathyroidism. A comprehensive study of clinical, biochemical and radiographic manifestations. Radiology. 109(3):513-24, 1973
                                                                              21. Simpson W et al: Skeletal changes in patients on regular hemodialysis. Radiology. 107(2):313-20, 1973