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EVIDENCE SYNTHESIS

Clinical Reference Hub

Curated insights • How it Works • Practical Pearls • Evidence Base

CLINICAL INSIGHT

When to Use

Evaluating patients with biochemically confirmed Primary Hyperparathyroidsm (PHPT).
Determining if an "asymptomatic" patient should proceed to parathyroidectomy.
Adhering to the Fifth International Workshop guidelines on Asymptomatic PHPT.

CLINICAL INSIGHT

How it Works

Biochemical / Age Thresholds

Parameter	Threshold for Surgery
Serum Calcium	> 1.0 mg/dL above ULN (> 2.8 mmol/L)
Age	< 50 years
T-score (DXA)	≤ -2.5 (Spine, Hip, or Distal Radius)
Vertebral Fracture	Presence of fracture on XR, CT, MRI, or VFA

Renal Criteria

Creatinine Clearance / eGFR < 60 mL/min.
24-hour urine calcium > 400 mg/day (or ethnicity-adjusted high).
Presence of Nephrolithiasis or Nephrocalcinosis on imaging.

CLINICAL INSIGHT

Practical Pearls

Distal Radius Importance

Silent Stones

CLINICAL INSIGHT

Evidence Base

Primary Source

Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism: Summary Statement from the Fifth International Workshop.

Bilezikian JP, et al.J Bone Miner Res2022

Clinical Reference Hub

When to Use

When to Use

How it Works

Biochemical / Age Thresholds

Renal Criteria

Practical Pearls

Distal Radius Importance

Silent Stones

Evidence Base

Primary Source

Primary Hyperparathyroidism Surgery Criteria (AACE/AAES)

Clinical Reference Hub

When to Use

When to Use

How it Works

Biochemical / Age Thresholds

Renal Criteria

Practical Pearls

Distal Radius Importance

Silent Stones

Evidence Base

Primary Source

Primary Hyperparathyroidism Surgery Criteria (AACE/AAES)

Clinical Evidence and Methodology

Clinical Reference Hub

When to Use

When to Use

How it Works

Biochemical / Age Thresholds

Renal Criteria

Practical Pearls

Distal Radius Importance

Silent Stones

Evidence Base

Primary Source

Primary Hyperparathyroidism Surgery Criteria (AACE/AAES)

Clinical Evidence and Methodology

Clinical Reference Hub

When to Use

When to Use

How it Works

Biochemical / Age Thresholds

Renal Criteria

Practical Pearls

Distal Radius Importance

Silent Stones

Evidence Base

Primary Source

Primary Hyperparathyroidism Surgery Criteria (AACE/AAES)