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How does a localizing test diagnose primary hyperparathyroidism?

The localizing tests do not diagnose hyperparathyroidism but are used by most surgeons to plan the operation. Localizing tests are radiology tests designed to help identify which parathyroid gland(s) are hyperactive. In the past, localization studies were not routinely performed before a first operation because a bilateral neck exploration (an operation where the surgeon examines all four parathyroid glands) was usually performed. However, if a focused parathyroidectomy (an operation where the surgeon examines and removes just the hyperactive gland) is going to be performed then accurate pre-operative localization is an essential component, so most patients undergo some form of pre-operative localization. 
 
 

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