![]() ![]() A surgeon will remove only those glands that are enlarged or have a tumor. Surgery is the most common treatment for primary hyperparathyroidism and provides a cure in most cases. If you choose this watch-and-wait approach, you'll likely need regularly scheduled tests to monitor your blood-calcium levels and bone density. You have no other symptoms that may improve with treatment.Your bone density is within the standard range or only slightly below the range.Your kidneys are working well, and you have no kidney stones.Your calcium levels are only slightly elevated.Your health care provider may recommend no treatment and regular monitoring if: Treatment options for primary hyperparathyroidism can include watchful waiting, surgery and medications. You feel confident that they're going to come here and get the care they need and deserve. What we strive for is really to have a very efficient and effective itinerary for patients and know they're going to be operated on by very high-volume, experienced parathyroid surgeons. In many of these cases, we're able to treat hyperparathyroidism and watch these symptoms literally go away. Patients can come into the office feeling a variety of symptoms that are generally nonspecific, but rather debilitating for them. Once that step is complete, then the patient can very confidently move towards the next step, which is treatment. And so with this type of scan, we can find parathyroid glands that are otherwise missed by traditional imaging techniques. It's really only available at a few centers across the country. It requires generation of a choline isotope onsite. So PET choline is one of the newest imaging modalities that's out there. And finally, cutting-edge imaging such as choline PET scan. We use four-dimensional CT scan, which is an advanced CT scan imaging of the neck and parathyroid glands. And that can include various imaging techniques such as ultrasound, parathyroid sestamibi scan, which is a nuclear medicine imaging. We utilize multimodal imaging, meaning various types of imaging to identify where the abnormal parathyroid is located. And most often, it's just one of them that develops a tumor of it. What they are are four little glands that regulate the calcium. And that ranges from the simplest primary hyperparathyroidism to the most complex cases. Here at the Mayo Clinic in Endocrine and Metabolic Surgery, we treat the full spectrum of parathyroid problems. A computer converts the echoes into images on a monitor. Ultrasound uses sound waves to create images of your parathyroid glands and surrounding tissue.Ī small device held against your skin (transducer) sends out high-pitched sound waves and records the sound wave echoes as they reflect off internal structures. Using this process, the thyroid image is digitally removed so it can't be seen.Ĭomputerized tomography (CT) scanning may be combined with the sestamibi scan to improve detection of any problems with the parathyroid glands. To keep the thyroid absorption from blocking the view of the absorption in a parathyroid tumor (adenoma), you're also given radioactive iodine. It can be detected by a scanner that detects radioactivity.Ī healthy thyroid gland also absorbs sestamibi. Sestamibi is a radioactive compound that is absorbed by overactive parathyroid glands. If your health care provider recommends surgery, one of these imaging tests may be used to locate the parathyroid gland or glands that are causing problems: Your provider may order an X-ray or other imaging tests of your abdomen to determine if you have kidney stones or other kidney problems. If a very low calcium level is found in the urine, this may mean it's a condition that doesn't need treatment. This test may help your provider determine the severity of hyperparathyroidism or diagnose a kidney disorder causing hyperparathyroidism. A 24-hour collection of urine can provide information on how well your kidneys work and how much calcium is passed in your urine. This test uses special X-ray devices to measure how many grams of calcium and other bone minerals are packed into a bone segment. The most common test to measure bone mineral density is dual-energy X-ray absorptiometry (DEXA). This test is done to see if you have developed osteoporosis. These tests include:īone mineral density test. These can rule out possible conditions causing hyperparathyroidism, identify possible complications and determine the severity of the condition. Additional testsĪfter diagnosing primary hyperparathyroidism, your health care provider will likely order more tests. But your health care provider can diagnose hyperparathyroidism if blood tests show you also have high levels of parathyroid hormone. Many conditions can raise calcium levels. ![]()
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