Styloid process phenotype and atheromatous plaque: Radiographic and bone density assessment in parathyroid disease

Area of Science:

• Endocrinology
• Radiology
• Bone Metabolism

Background:

• Parathyroid diseases, including primary hyperparathyroidism (PHPT) and post-surgical hypoparathyroidism (hypoPT), significantly impact bone mineral density and cardiovascular health.
• Radiographic assessment of specific anatomical structures may offer insights into the systemic effects of these conditions.

Purpose of the Study:

• To evaluate the styloid process (TBSP) phenotype and the prevalence of calcified atheromatous plaques (CAP) in panoramic radiographs of patients with PHPT and hypoPT.
• To investigate the association between bone mineral status and these radiographic findings in patients with parathyroid disorders.

Main Methods:

• A cross-sectional case-control study involving 25 patients with PHPT, 25 with post-surgical hypoPT, and 50 controls.
• Panoramic radiographs were analyzed for styloid process length and mineralization patterns, and for the presence of CAP.
• Bone mineral density (BMD) was assessed and correlated with radiographic measurements.

Main Results:

• Elongated TBSP (length >30 mm) was more frequent in both PHPT and hypoPT groups compared to controls.
• CAP was more prevalent in the PHPT group.
• Low BMD was associated with PHPT, and in this group, low BMD correlated with increased TBSP length and a higher frequency of elongated TBSP. Femoral neck T-score showed an inverse relationship with TBSP length in PHPT patients.

Conclusions:

• Distinct radiographic findings of TBSP and CAP are observed in patients with PHPT and hypoPT compared to controls.
• In PHPT patients, low bone mineral density is associated with a higher prevalence of elongated TBSP, suggesting a link between bone status and styloid process morphology.