Preoperative Evaluation of Bone Mass Using Dual X-Ray Absorptiometry and Quantitative Ultrasound in Postmenopausal Women with Primary Hyperparathyroidism

Abstract

BACKGROUND: Primary hyperparathyroidism (PHPT) is the third most frequently diagnosed endocrine disorder worldwide. The aim of our study was to evaluate quantitative ultrasound (QUS) parameters of the hand in postmenopausal women with PHPT preoperatively, so that we may develop an effective method to compare the benefits of the patients after a successful parathyroidectomy. We hypothesized in this study that QUS evaluation of the hand may have an extra advantage in the assessment of cortical bone quality in patients with PHPT than standard bone density measurements with dual-energy X-ray absorptiometry (DXA). METHODS: Sixteen postmenopausal women who had been diagnosed with primary hyperparathyroidism and 16 age-matched post-menopausal women were enrolled in the study. Bone mineral density (BMD) measurements were performed by dual-energy X-ray absorptiometry (DXA) at the lumbar spine (L1–L4) and proximal femur (neck and total). Ultrasound measurements were performed at the 1/3 distal radius (RAD) and proximal phalanges of the third finger (PLX) on the non-dominant hand. RESULTS: All parameters of the QUS measurements (T-scores for RAD and PLX, ORI™) were significantly lower in the PHPT group than in the control group (p < 0.05). However, there was no significant difference between the patients with PHPT and the control group when evaluated by DXA. CONCLUSIONS: This study indicates that QUS could be an alternative diagnostic approach in evaluating bone mass in post-menopausal women with PHPT since it reflects early bone loss in these patients better than DXA measurement.