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Editorials |

Primary Aldosteronism—One Picture Is Not Worth a Thousand Words

William F. Young Jr., MD, MSc
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From Mayo Clinic, Rochester, MN 55905.


Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: William F. Young Jr., MD, MSc, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; e-mail, young.william@mayo.edu.


Ann Intern Med. 2009;151(5):357-358. doi:10.7326/0003-4819-151-5-200909010-00013
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Physicians often rely on imaging to guide clinical decision making. When computed tomography (CT) or magnetic resonance imaging (MRI) is used to demonstrate adrenal morphologic appearance in patients with primary aldosteronism, the images may lead to errors in clinical management. In this issue, Kempers and colleagues (1) report a systematic review of the diagnostic procedures to distinguish between unilateral and bilateral adrenal disease in patients with primary aldosteronism. Their key finding, based on 950 patients with primary aldosteronism from 38 studies, is that the adrenal morphologic appearance on CT or MRI does not accurately identify the source of aldosterone excess (1).

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