The vast majority of parathyroid adenomas are found on exploration of the neck, providing that the surgeon is experienced. Pre-operative ultrasonography can, however, be helpful, as in this patient where an enlarged parathyroid was demonstrated adjacent to the upper pole of the left lobe of the thyroid. The finding of a solitary enlarged parathyroid gland is likely to indicate an adenoma rather than parathyroid hyperplasia and is an aid to planning surgery. Intrathyroid parathyroid glands cannot be distinguished on ultrasonography from other thyroid nodules. (See also Chapter 25, Fig. 25.11.)
