The use of ultrasonography in the management of parathyroid diseases

Ultrasound affords certain key advantages in general and specifically for parathyroid disease management. It can be readily performed in the office and even portably in the operating room, allows real-time examination that is noninvasive and comfortable for the patient, identifies co-existing -thyroid pathology that may require treatment, and can be performed by a clinician who is evaluating the patient with access to all relevant clinical information. Recognizable sonographic features allow identification of abnormal parathyroid glands, can be readily learned, and make ultrasound a powerful tool especially when performed by clinicians with access to comprehensive information about the patient's parathyroid disease. Ultrasound can guide appropriate interventions to clarify challenging diagnostic scenarios, although ultimately it should not be viewed as a diagnostic test for hyperparathyroidism. It has a demonstrated history of valuable clinical use. The following review highlights these advantages, describes the technical and anatomical findings expected with parathyroid ultrasound, relates the specific indications for its use, and presents an overview of reported performance as a localizing study in the management of hyperparathyroidism.