Strategy for the diagnosis and treatment of bone diseases caused by primary hyperparathyroidism
SANG Shang
ZHANG Zhi-chang
QIN Shu
ZHANG Jing
DONG Yang
Abstract：Objective To summarize the strategy for diagnosis and treatment of bone disease caused by primary hyperparathyroidism ( PHPT ). Methods The clinical data of 26 patients with PHPT treated in our hospital were analyzed; 6 were male and 20 female. Their mean age was 50 years ( ranging from 13 to 83 ). All of the 26 patients had symptoms of pain, including 6 patients with movement disorders, 5 patients with fatigue. Laboratory examination showed that the patients had hypercalcemia, hypophosphatemia and raised parathyroid hormone ( PTH ). Skeletal imaging examination showed decrease in bone density, cystic bone absorption and absorption in phalangeal cortical bone. All patients were transferred to the Department of General Surgery for parathyroid adenoma resection. After the surgery, 1 patient was treated with nidus curettement, bone graft and internal fixation and 1 patient with postoperative fracture was treated with open reduction and internal fixation. Results There were significant pain relief in 25 patients ( the VAS scores were less than 3 points ) and the time required for the relief of pain ranged from 3 days to 1.5 years and most of the patients need less than 6 months. One patient got fracture, the rest of the patients had no fractures. Conclusions Patients with bone pain, pathologic fractures should be suspected of PHPT. Further examination, such as the level of serum calcium and PTH and parathyroid ultrasonography and skeletal imaging examination, can help the diagnosis. After the resection of the parathyroid adenoma, the long term prognosis of patients with PHPT is favorable and the complications are rare.
Keywords：HyperparathyroidismBone densityOsteopathic medicineHypercalcemia
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 690-694 )