 OFC may be diagnosed using a variety of techniques . Muscles in patients afflicted with OFC can either appear unaffected or " bulked up . " If muscular symptoms appear upon the onset of hyperparathyroidism , they are generally sluggish contraction and relaxation of the muscles . Deviation of the trachea ( a condition in which the trachea shifts from its position at the midline of the neck ) , in conjunction with other known symptoms of OFC can point to a diagnosis of parathyroid carcinoma . 
