If a patient has a history of hyperparathyroidism, which site is preferred for evaluation?

• A. Wrist
• B. Hip
• C. 33% or 1/3 of the forearm
• D. Lumbar spine

Answer: (C)

The preferred site for evaluation in a patient with a history of hyperparathyroidism is the distal forearm, specifically the 33% or 1/3 region of the forearm. This choice is based on the fact that hyperparathyroidism often leads to alterations in bone density and increases the risk of fractures, especially in cortical bone. The forearm is primarily composed of cortical bone, which is particularly affected in this condition.

In hyperparathyroidism, the parathyroid hormone elevates calcium levels by stimulating bone resorption, which can lead to localized effects on bone density. The 1/3 region of the forearm is sensitive to these changes and can provide valuable information on cortical bone health and overall fracture risk.

While other sites like the hip, lumbar spine, and wrist are also evaluated for bone density, they may not provide as specific or sensitive information regarding changes in cortical bone that occur with hyperparathyroidism. For example, the lumbar spine predominantly consists of trabecular bone, which can respond differently to parathyroid hormone actions. The hip, while critical for assessing overall bone health, may be less specific for changes due to hyperparathyroidism compared to the forearm. Therefore, evaluating the 33% or