New insights into the effects of primary hyperparathyroidism on the cortical and trabecular compartments of bone

Abstract

In primary hyperparathyroidism (PHPT), protracted elevation of serum parathyroid hormone (PTH) is held to be associated with cortical, but not trabecular, bone loss. However, an alternative explanation for the apparent preservation of trabecular bone is fragmentation of the cortex by intracortical remodeling. The cortical fragments resemble trabeculae and so may be erroneously included in the quantification of 'trabecular' bone density.To test this hypothesis, we compared bone microarchitecture in 43 patients with untreated PHPT (mean 62.9. years, range 31-84) with 47 healthy age-matched controls and 25 patients with surgically treated PHPT (63.6. years, 30-82). Images of the distal radius a..