Estimation of Skeletal Involvement in Primary Hyperparathyroidism

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Abstract
The 24 h whole-body retention of Tc-99m diphosphonate was elevated in 16 patients with primary hyperparathyroidism (mean whole body retention, 50.6%, compared to controls, 19.4%), with each result out of the control range. There was a rank correlation between whole-body retention and plasma parathyroid hormone (r = 0.86, P < 0.001) but the correlation with serum alkaline phosphatase and Ca values was less significant (r = 0.58, P < 0.05 in each case). Repeat studies of whole body retention performed in 5 patients before and after parathyroidectomy showed a fall to normal or near normal values. Measurement of 24 h whole-body retention of diphosphonate is a simple, sensitive test to aid in the diagnosis and evaluation of patients with primary hyperparathyroidism. The test could be used as a screening procedure in patients with recurrent renal stones, or to assess the extent of skeletal involvement in patients with an established diagnosis.