Quantitative ultrasound and bone mineral density in patients with primary hyperparathyroidism before and after surgical treatment

The aim of this study was to assess the pattern of ultrasound (QUS) paramet ers and bone mineral density at different skeletal sites in patients with p rimary hyperparathyroidism (PHPT) before and after surgical treatment. In 2 2 patients (age range 28-74 years) with PHPT we measured speed of sound (SO S), attenuation (BUA) and Stiffness at the calcaneus, amplitude-dependent s peed of sound (AD-SoS) at proximal phalanges, and bone mineral density at l umbar spine (BMD-LS) and at the mid-radius (BMD-MR) and ultradistal radius (BMD-UDR) before, 1 and 2 years after surgical operation. Twenty-two age- a nd sex-matched healthy subjects provided control data. Before surgery, all parameters apart from SOS were significantly lower in PHPT patients than in controls. At the end of the study period, BMD-LS increased by 7.0%, BMD-UD R by 7.4% and BMD-MR by 11.0%. The changes in ultrasound parameters after s urgery were lower (0.44% for SOS, 2.2% for BUA, 3.3% for Stiffness and 2.6% for AD-SoS); however, the increase was statistically significant (p<0.05 a nd p<0.01, respectively) only for Stiffness and AD-SoS, Our results indicat e that parathyroidectomy increases both axial and appendicular BMD and infl uences QUS parameters differently at the calcaneus and at the phalanges. Th e combined use of BMD and QUS could improve the assessment of skeletal stat us in patients with PHPT before and after surgery.