ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1595940
Ultrasound Detection of Normal Parathyroid Glands: Detection Rate, Topographic Anatomy, and the Role of Underlining Thyroid Disease
Provisionally accepted
Isabella Chiardi1,2*
Petra Makovac3Andrea Leoncini3Flavio Forte4
Mario Rotondi1,5Pierpaolo Trimboli2,6*- 1University of Pavia, Pavia, Lombardy, Italy
- 2Unità di Diabetologia ed Endocrinologia, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland
- 3Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
- 4M.G. Ospedale Vannini, Rome, Lazio, Italy
- 5Scientific Clinical Institute Maugeri (ICS Maugeri), Pavia, Italy
- 6University of Italian Switzerland, Lugano, Ticino, Switzerland
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Visualizing normal parathyroid glands (PTGs) using ultrasound (US) has historically been challenging. This study aims to assess the detection rate of normal PTGs in thyroid patients and evaluate their echostructure, anatomical location and their relation with the underlying thyroid pathology. A retrospective observational study was conducted over four weeks (September–October 2024) at the Thyroid Unit of Ente Ospedaliero Cantonale (EOC). Consecutive thyroid patients undergoing US for any thyroid indication were included, while those with a history of parathyroid disease, chronic kidney disease, or recent thyroid surgery were excluded. The primary outcome was the detection rate of normal PTGs. Secondary outcomes included PTG echostructure, anatomical location, and correlations with patient characteristics (age, gender, BMI, thyroid volume, and underlying thyroid pathology).Normal PTGs were identified in 45.1% of patients (n=51). Most PTGs were located near the lower pole of the thyroid lobes and appeared mildly hyperechoic. Thyroid volume was inversely associated with PTG detection (p=0.001), while underlying thyroid pathology (e.g., thyroiditis, nodular disease) had no significant impact on detection rates.Normal PTGs can be visualized using US, particularly near the lower thyroid poles. Detection rates decrease in patients with larger thyroid volumes or athyreotic status. These findings confirm and expand on recent studies, challenging the historical belief that normal PTGs are undetectable, with potential implications for endocrine imaging and surgical planning.
Keywords: Conceptualization, P.T, methodology, I.C and P.T., software, I.C., validation, P.T., formal analysis, I.C and P.T., investigation, I.C and P.T., data curation, I.C and P.T, writing-original draft preparation, I.C, writing-review and editing, I.C, P.M, F.F., M.R and P.T.
Received: 18 Mar 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Chiardi, Makovac, Leoncini, Forte, Rotondi and Trimboli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Isabella Chiardi, University of Pavia, Pavia, 27100, Lombardy, Italy
Pierpaolo Trimboli, Unità di Diabetologia ed Endocrinologia, Ospedale Regionale di Lugano, Lugano, 6500, Ticino, Switzerland
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