Mandatory medical device diagnostics.
- The following procedures are suitable for determining the location of a possible adenoma:
- Magnetic resonance imaging (MRI) – computer-assisted cross-sectional imaging procedure (using magnetic fields, i.e. without X-rays).
- Sonography (ultrasound examination)
- Spiral computed tomography (CT)
- 99mTc-MIBI (methoxyisobutyl-isonitrile) scintigraphy
- Nuclear medicine procedure that can depict functional changes in the skeletal system in which regional (local) pathological (pathological) increased or decreased bone remodeling processes are present.
- High sensitivity (percentage of diseased patients in whom the disease is detected by the use of the procedure, ie, a positive finding occurs).
- Possibly in combination with single photon emission tomography (SPECT; functional imaging method of nuclear medicine, with which based on the principle of scintigraphy cross-sectional images of living organisms can be created).
- X-ray of the acras (hands and feet), spine, skull.
- Diffuse osteopenia (decrease in bone density) is the most common sign in the context of primary hyperparathyroidism
Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification.
- If neuromuscular symptoms: electrocardiogram (ECG; recording of the electrical activities of the heart muscle).
- QT shortening
- Osteodensitometry (bone densitometry) – As part of conservative therapy for primary hyperparathyroidism, osteodensitometry should be performed on the radius (radius near the wrist), lumbar spine, and femur (thigh bone) every two years.
- Pathognomonic (evidence of disease) for primary hyperparathyroidism are subperiosteal resorption lacunae (bulges on bone surfaces located below the periosteum) and osteitis fibrosa cystica – breakdown of bone substance and replacement by connective tissue (“brown tumors”).
- In the early stage, osteodensitometry reveals signs of cortically accentuated osteopenia (reduction in bone density).
- Sonography (ultrasound examination) of the kidneys and urinary tract.
- Urinary stone formation (urolithiasis or nephrolithiasis (urinary/renal stones))?