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Primary hyperparathyroidism is most commonly (85% of cases) due to a single hyper-functioning gland.

This gland can be localized through a number of imaging investigations. Most commonly used in South Africa are isotope scans; these give a rather fuzzy image but allow for functional-anatomical correlation. We have recently adopted ultrasound which gives a very detailed image of the neck allowing for clear identification of the hyper-functioning gland.

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