Modern approaches to assessing bone disorders in primary hyperparathyroidism: the potential of 3D-modeling of the femur

Primary hyperparathyroidism (PHPT) is a common endocrine disease with excessive secretion of parathyroid hormone and impaired mineral metabolism, resulting in decreased bone mineral density (BMD) and increased fracture risk. Radiography, dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), high-resolution peripheral QCT (HRPQCT) and radiofrequency echographic multispectrometry (REMS) have traditionally been used to assess bone density. However, these methods have certain limitations, therefore the search for new diagnostic approaches is necessary. In recent years, 3D femoral bone modelling (3D-DXA) has been actively developed, which allows three-dimensional analysis of bone density and structure based on DXA data. This method demonstrates high accuracy and correlation with CT, providing a more detailed assessment of changes in the cortical and trabecular components. The use of 3D-DXA opens new perspectives in the diagnosis and monitoring of bone complications in PHPT, which may contribute to more effective fracture risk prediction and personalised choice of therapeutic tactics.