Parathyroid sonography in secondary hyperparathyroidism: correlation with clinical findings

We present the results of ultrasonic neck examination in 72 patients (47 males, 25 females) on chronic haemodialysis, with clinical and biochemical signs of increased function of the parathyroid glands. The findings of the ultrasonic examination performed using linear transducers of 5 and 7.5 MHz for the surface tissue are compared with the duration of haemodialysis treatment, biochemical parameters (calcium, phosphate, parathormone, alkaline phosphatase) and skeleton X-ray findings. In 18 patients parathyroid glands were not visible, in 30 patients there were one or two enlarged (i.e. abnormal) parathyroid glands, and in the remaining 24 patients three or four of the glands were enlarged. Abnormal parathyroid glands were more often found in patients who had been dialysed for a longer period of time, as well as in those with a higher parathormone level in the blood. It is concluded that ultrasonic examination of the neck is very useful in the diagnosis of enlarged parathyroid glands, and helpful in the management of patients on chronic haemodialysis.