December 16, 2020
DEC 16, diagnostic imaging: parathyroid scanning
Authors' Note: Attacks of renal colic (spasmodic intermittent pain) may occur due to blockage of urine flow by stones in the ureters. In adult patients, stones consisting of calcium salts are most likely. If a high serum calcium level is found (this situation prevails in only a minority of cases of kidney stones), overactivity of the tiny parathyroid (PT) glands may be responsible. Milder cases of excessive parathyroid hormone secretion may also occur without symptoms, but can lead to loss of bone mass and increased risk of bone fracture.
A single functioning adenoma (benign tumor) of one of the PT glands is most commonly responsible, but hyperplasia (overgrowth) of all four glands may also result in inappropriate PT hormone secretion, detected by increased blood levels. The radiotracer Tc-99m sestamibi is taken up selectively by overactive PT glands, and may help plan surgery to explore the neck and remove the tumor.