Quantitative Ultrasound and Bone Mineral Density in Patients with Primary Hyperparathyroidism Before and after Surgical Treatment

Gonnelli, Stefano; Montagnani, A; Cepollaro, C.; Monaco, Roberto; Gennari, Luigi; Rossi, Benedetta; Pacini, Sonia; Gennari, C

doi:10.1007/s001980050289

Cited by 40 publications

(30 citation statements)

References 32 publications

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“…SOS in the calcaneus increased too, but only the difference between present and baseline measurements was significant, since the difference between the present and the last measurement (5 years ago) was not. Our results of greater response of SOS in the phalanges than in the calcaneus are similar to those reported by other authors [3]. The BUA value decreased (not significant according to LSC) in comparison to the last measurement, and SI remained the same, although they both were higher than baseline results.…”

Section: Discussionsupporting

confidence: 92%

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Seven-year follow-up in a case of primary hyperparathyroidism using quantitative ultrasound and dual X-ray absorptiometry

2007

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AbstractWe have previously reported a case of a 36-year-old woman who was diagnosed with primary hyperparathyroidism following initial skeletal abnormalities in the hand phalanges and calcaneus revealed by quantitative ultrasound (QUS). Successful parathyroid adenoma surgery resulted in progressive increase of bone mineral density and QUS parameters within 6 months, 1 year and 2 years of follow-up. Now, 5 years after the last measurement and at the onset of her menopause, the study was repeated. It has shown further increase in some ultrasonic and densitometric parameters but decrease in others. This discrepancy could be associated with the early influence of perimenopause on trabecular bone. Based on the current report one can conclude that peripheral QUS used on the hand phalanges and calcaneus is a useful tool for the diagnosis and monitoring of skeletal alterations due to parathyroid dysfunction. Moreover, it can detect early changes associated with perimenopause.

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Section: Discussionsupporting

confidence: 92%

“…Quantitative ultrasound (QUS) is a widely accepted method for the diagnosis of skeletal status in postmenopausal osteoporosis and different metabolic bone diseases [2]. There are several studies on QUS measurements in patients with PHPT [3,4].…”

Section: Introductionmentioning

confidence: 99%

Seven-year follow-up in a case of primary hyperparathyroidism using quantitative ultrasound and dual X-ray absorptiometry

2007

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“…At the same time, bone density increases. Recent long-term data on the course of treated and untreated asymptomatic primary hyperparathyroidism have confirmed that successful surgery leads to sustained increases in bone mineral density at sites rich in cancellous bone such as the lumbar spine, where a mean rise of 12% in bone mass is seen after parathyroidectomy (8,21,41,42). In line with this increase in bone density, there is preliminary (case-control) evidence to suggest that surgery might reduce the risk of subsequent fracture (43).…”

Section: Management Of Primary Hyperparathyroidism -Treating Older Pamentioning

confidence: 93%

Primary hyperparathyroidism: diagnosis and management in the older individual

Boonen

Vanderschueren²,

Pelemans³

et al. 2004

European Journal of Endocrinology

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As more and more cases of primary hyperparathyroidism are being detected by screening for serum calcium concentration, the majority of patients are older individuals who are asymptomatic or have symptoms which are difficult to ascribe to hyperparathyroidism. Long-term follow-up has provided evidence that most asymptomatic patients who do not undergo parathyroidectomy will not develop symptomatic complications. Some asymptomatic patients, however, have progression of disease over time. These observations and the lack of reliable predictors of the rate of progression in most patients reinforce the need for careful monitoring in elderly individuals who do not undergo surgery. Biannual measurements of serum calcium concentrations and annual measurements of urinary calcium excretion and bone mineral density should be performed in all patients who are managed conservatively. In elderly patients with symptomatic or complicated primary hyperparathyroidism, parathyroidectomy results in biochemical cure and increased bone density, both at the lumbar spine and the femoral neck, and should be considered. Criteria for surgery include significant hypercalcemia (.1 mg/dl above the upper limit of normal), marked hypercalciuria (. 400 mg per day), low bone density, unexplained renal insufficiency and an episode of acute primary hyperparathyroidism. Consideration of parathyroidectomy should also be given to elderly patients with primary hyperparathyroidism who are vitamin D deficient. Radionuclide scanning has become the initial non-invasive study of choice when parathyroid gland localization is necessary before parathyroidectomy; this is generally for fragile patients and reoperative cases. In a subset of older individuals, surgery may not be an option because of coexisting medical problems even though surgical indications are present.European Journal of Endocrinology 151 297-304

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“…The ability of ultrasound measurements to detect bone growth and ageing and to assess fracture risk in various metabolic bone diseases was presented in a review [10]. Among other studies, phalangeal ultrasound measurements were also used in the detection of various hormonal disorders [11,12]. There are differences among studied populations, and there is no available data on ultrasound measurements of phalangeal bones in healthy adolescents of the Lower Silesia region.…”

Section: Introductionmentioning

confidence: 99%

Quantitative ultrasound at the hand phalanges in adolescent boys in relation to their pubertal development and physical efficiency

Chwałczyńska¹,

Pluskiewicz²,

Syrycka³

et al. 2013

Endokrynologia Polska

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Introduction: Our aim was to assess the ultrasound properties of bone measured at hand phalanges in 55 adolescent boys aged 13-15 years regarding the influence of pubertal status and level of physical efficiency including muscular strength. Material and methods: They were divided into two age groups: Group I (n = 37, boys aged 159-171 months) and Group II (n = 18, aged 172-184 months). The controls were 94 boys matched for age, recruited from 1,256 subjects undergoing bone measurement for screening purposes. The skeletal status (amplitude-dependent speed of sound -Ad-SoS) was assessed by quantitative ultrasound (QUS) at proximal phalanges with the use of DBM Sonic 1200. Physical efficiency was assessed using Zuchora's test, and pubertal development by Tanner's score. Results: There was no difference in mean Ad-SoS between the entire study group and controls. Ad-SoS values were greater in older than in younger boys, both in right and left hands. There were no differences between left and right hand measurements. There were positive correlations between Ad-SoS and shoulder muscle strength in boys. Negative correlations between Ad-SoS at phalanges of right and left hand and BMI were shown in younger adolescent boys only. Similarly, only in the younger group were positive correlations present between both hands Ad-SoS and overall physical efficiency and age. Ad-SoS correlated positively better with Tanner's scale scoring in the older group. Conclusions: QUS at hand phalanges in adolescent boys aged 13-15 years depends on pubertal development and shoulder muscle strength. The overall physical efficiency has limited influence on bone properties assessed by QUS.

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Quantitative Ultrasound and Bone Mineral Density in Patients with Primary Hyperparathyroidism Before and after Surgical Treatment

Cited by 40 publications

References 32 publications

Seven-year follow-up in a case of primary hyperparathyroidism using quantitative ultrasound and dual X-ray absorptiometry

Seven-year follow-up in a case of primary hyperparathyroidism using quantitative ultrasound and dual X-ray absorptiometry

Primary hyperparathyroidism: diagnosis and management in the older individual

Quantitative ultrasound at the hand phalanges in adolescent boys in relation to their pubertal development and physical efficiency

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