Introduction and objectives: In the 4th Workshop on Primary Hyperparathyroidism, it is recommended to perform BMD by DXA of third radius as well as lumbar spine and hip DXA in the initial assessment and follow up of patients with primary hyperparathyroidism. This test is not available in many centers, which means that only T Score values of the lumbar spine and hip are used to certify the absence of osteoporosis in asymptomatic patients wich conservative management is performed. Our objective is to evaluate if the recent addition of radius DXA has modified the management of this patients.
Materials and methods: Retrospective study including patients in follow-up by primary asymptomatic hyperparathyroidism in conservative management according to the Fourth Workshop criteria when radial densitometry for the first time in its evolution. Changes after the DXA results were evaluated.
Results: 20 patients (65.4 years ±11.14, 90% women) with a follow-up of 3.95 years ±1.97 were included. Blood calcium levels 11.05±0.45 mg/dl, mean PTH of 105.46 pg/ml ±60.9. None presented lumbar and/or femoral T-Score scores values lower tan −2.5 DS (lumbar T −0.15 DS ±2.17, femoral −0.77 DS ±0.98). The radial T Score was −2.67 DS ±2.45. The radial densitometry results changed the clinical attitude in 70% of the patients, from the recommed conservative management to surgical treatment in those with a T-Score lower −2.5 DS in the distal radius and T-Score higher than −2.5 DS in the lumbar and/or femoral.
Conclusions: Our study reinforces the importance of performing distal radius densitometry in patients in which conservative management is giving to be performed, as is recommended as recommended by international criteria. Lack of implementation may lead to conservative management in patients with osteoporosis.
20 May 2017 - 23 May 2017