How do you approach a patient with biochemical evidence of primary hyperparathyroidism, but normal parathyroid scan?  

Negative sestamibi scans are not unusual in patients with primary hyperparathyroidism. Other imaging tests may be negative also. If the patient has biochemical evidence of the problem and has even mild complications referral to an experienced parathyroid surgeon would be warranted. Alternatively, ci...

It's not infrequent to see biochemical evidence of Primary hyperparathyroidism and negative/non-localizing Sestamibi scan, its sensitivity and specificity is 70-80%.  At our institution, we have 4-D CT imaging and ultrasound by an experienced ENT surgeon, and rarely do we come across an ectopi...

This is really not a nephrology question, but I was once told by an endocrinology surgeon that there is no role for a parathyroid scan, and that the imaging is surgery. Besides, people can have 5 glands, one hidden in the mediastinum. Now that "no need for imaging" is a bit egotistical, but there is...

Anatomical exploration by the surgeon is the way to confirm the location of the adenina and the means for treatment. The functional diagnosis is always a biochemical one. Sestamibi PTH scan is known to lack sensitivity. Additionally, PTH gland anatomy presents one of the greatest variations in natur...