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Once a decision for surgery has been made and the surgeon has selected the desired imaging prior to the surgery, what actually takes place during the operation? How does the surgeon determine which gland or glands are abnormal?

The answers to these questions are not quite as straightforward or consistent among surgeons as one might expect. There are a variety of...


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Once the diagnosis of primary hyperparathyroidism has been established from the calcium and PTH levels, and a decision for surgery is made, the next step is usually to determine what additional information should be obtained in order to assure a successful operation.

This is where imaging becomes useful.

It is worth repeating the central poi...


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It is extremely important to understand that we do not need imaging to make a diagnosis of primary hyperparathyroidism. The diagnosis is based on the laboratory findings.

Sometimes those findings are very clear, and sometimes they fall into a gray zone.

If the calcium is repeatedly high and the parathyroid hormone level is elevated—or...


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