Which statement describes an indication for parathyroidectomy?

• A. Asymptomatic hyperparathyroidism with mild hypercalcemia
• B. Symptomatic hyperparathyroidism with osteoporosis (DEXA -2.5)
• C. Hypoparathyroidism
• D. Thyroid nodule

Answer: (B)

The main idea is that parathyroidectomy is indicated when primary hyperparathyroidism causes symptoms or complications that surgery can reliably prevent or reverse. Osteoporosis on a DEXA scan (T-score -2.5) shows bone loss due to excess PTH-driven bone resorption. Removing the overactive parathyroid tissue often halts further bone loss and can improve bone density, reducing fracture risk, which is why this scenario clearly warrants surgery.

Asymptomatic hyperparathyroidism with only mild hypercalcemia is typically managed conservatively unless there are other risk factors or complications. Hypoparathyroidism is the opposite condition and wouldn’t indicate removing parathyroid tissue. A thyroid nodule is unrelated to parathyroid disease.