Teaching Points
- Imaging for pre-operative localisation of the parathyroid glands remains controversial although it is generally recommended for minimally invasive or unilateral neck surgery.
- Ultrasound and Sestamibi scans are sensitive methods used as first line investigations, frequently in combination.
- CT and MRI have the advantage of superior anatomical localisation but are usually reserved for equivocal or negative ultrasound and nuclear medicine studies.
- Preoperative imaging is required for recurrent or persistent hyperparathyroidism to minimise the risks of repeat surgery and to maximise the chances of succesful treatment.
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