Make your choice: Angiography or periodical health examination?

Periodical health examination is one of the important factors influencing a healthy lifestyle. Patients undergoing routine physical examination in primary care are included in the scope of preventive medical services, which is the most basic principle of primary care. Identifying the risk factors enables individuals to adopt healthier lifestyle practices. In our study, we examined the correlation between patients undergoing coronary angiography for suspected coronary stenosis and the extent of primary care services they had received in their medical history, along with the severity of stenosis observed during the angiography. Patients were interviewed using a pre-structured questionnaire to gather information about their past utilization of primary healthcare services related to coronary matters and their cardiovascular (CV) risk profile as documented in their medical history. The necessary standard tests for angiography procedures were retrieved from patient records. The SYNTAX score, a tool that aids in the objective assessment of the severity of coronary artery disease (CAD), was computed and documented. This score was then compared with the history of primary care utilization. The patients' utilization of services from the Primary Healthcare Center (PHC) was evaluated using a scoring system, with an average score of 29.27 ±â€…11.27 out of 100 points (minimum: 20; maximum: 60). The average SCORE Türkiye indicating the 10-year risk of CV events for all patients was calculated as 14.31% ±â€…8.65% (high-very high risk), while the average SYNTAX score was 15.20 ±â€…9.97. There was a positive and significant correlation found between fasting blood glucose and creatinine values with both SYNTAX score and SCORE Türkiye (respectively; R = 0.238, P = .013; R = 0.289, P = .002). Factors such as smoking and metabolic syndrome were associated with CAD severity. It important to highlight that individual recommended for angiography had a notably lower utilization of healthcare services from the PHC based on their medical histories. This circumstance has resulted in individuals who do not undergo CV event screenings at PHCs having higher SYNTAX scores, indicating more severe CAD that necessitates angiography. Conducting regular periodical health examinations at PHCs can help mitigate these statistics.

Reliability and validity of the Turkish version of the elder abuse suspicion index in community-dwelling older adults.

BACKGROUND: Elder abuse is among the most important ethical issue during the management of older population. The elder abuse suspicion index (EASI) was developed for evaluating abuse in older adults. We aimed to assess the reliability and validity of the Turkish version EASI-Türkiye (TR) among older adults. METHODS: This study included 89 community-dwelling older adults. The EASI-TR and other scales, including HwalekSengstock Elder Abuse Screening Test-Türkiye (HS/EAST-TR), YGDS, Yesavage Geriatric Depression Scale (YGDS), Instrumental Activities of Daily Living (IADL), and Activities of Daily Living (ADL) were administered to all participants. Internal consistency and external validity were assessed. RESULTS: EASI-TR revealed an excellent test-retest reliability and acceptable level of internal consistency (Cronbach's α = 0.711). The item-total correlations ranged between 0.296 and 0.701, except for the second item. This test showed significant correlations with the HS/EAST-TR and IADL (p < 0.05), demonstrating good external validity. DISCUSSION: The EASI-TR appears to have acceptable reliability and validity in screening for abuse in older adults. This tool may recognize cases that require additional evaluation in managing of ethical issues.

Planned and unplanned pregnancy and its association with coping styles and life quality.

We aimed to compare women who have a planned pregnancy with women who have an unwanted pregnancy, in terms of quality of life, coping attitudes, and demographics. 172 pregnant women were enrolled, of whom 128 of them had planned pregnancy, and 44 of them had not. A survey of socio-demographics, COPE inventory, and SF-36 tools are used to investigate and compare coping attitudes and quality of life. The chi-square test was used to compare categorical variables between groups. The overall quality of life was found to be similar between the two groups. Problem-focused coping attitudes of expectant mothers and dysfunctional coping behaviors were more common among mothers with planned pregnancies (p = 0.047 and p = 0.036, respectively). The planning status of the pregnancy doesn't seem to be affecting the expectant mothers' quality of life substantially. On the other hand, unplanned pregnancies appear to be associated with some coping behaviors, as well as low-income level, exposure to violence and not having social support. This outcome may be helpful for pre-conceptional consultations, especially for pregnant with a lack of coping attitudes.

HIV Seroprevalence in Mogadishu, Somalia: a Retrospective Study between 2015 and 2019.

BACKGROUND: Acquired immunodeficiency syndrome (AIDS) remains a major global public health problem. This study aimed to obtain current epidemiological data on the Human immunodeficiency virus (HIV) infections in Mogadishu, Somalia. METHODS: This study included 92,270 anti-HIV test results reported for 82,954 different individuals between 2015 and 2019. HIV tests were performed using the Architect HIV Ag/Ab Combo assay and retested with the Elecsys HIV combi PT assay. RESULTS: HIV seropositivity was found to be 0.32% (269/82,954) in all individuals over a period of four years. Anti-HIV seropositivity in the 0 - 14, 15 - 19, 15 - 24, 15 - 49, and > 15 age groups were as follows: 0.17% (11/6,441), 0.17% (12/7,131), 0.15% (35/24,132), 0.37% (212/56,895), and 0.34% (258/76,513), respectively. In HIV-infected patients, anti-HBs, HBsAg, anti-HCV, and anti-TP (syphilis) seropositivity was found to be 30.3% (56/185), 9.54% (23/241), 1.24% (3/242), and 3.45% (2/58), respectively. CONCLUSIONS: The findings from this study provide comprehensive data on the HIV epidemiology in Somalia. We believe that the results presented in this study will contribute to the risk analysis and planning of preventive policies of national and global health organizations.

The effect of cancer diagnosis in first-degree relatives on participation of healthy individuals in cancer screening programs and on their attitudes towards healthy lifestyle changes.

Background: Ensuring that first-degree relatives of patients diagnosed with cancer are included in the cancer screening programs will reduce the negative effects that may arise both for the individuals having the risk of cancer and for the community. In our study, we aimed to investigate the awareness and attitudes of the first-degree relatives of patients, who have received diagnosis of a cancer, toward cancer screening programs and to determine the risk factors for cancer. Methods: A questionnaire prepared by the researchers was conducted over the relatives of 234 cancer patients for determining their awareness about cancer and their attitudes toward participation in cancer screening programs. The data were analyzed using SPSS 22 software package. Results: 72.6% of the participants never heard about Cancer Early Diagnosis, Screening and Training Center, which has been established to carry out cancer screening programs in Turkey. Approximately half of the female participants did not participate in breast cancer and cervical cancer screenings (54.9% and 51.1%, respectively). The rate of those who had screening tests for colon cancer was less than one-fifth of all participants (19.8%). The above data show the low level of awareness of the participants about cancer. Conclusion: It has been observed that diagnosis of cancer in the first-degree relatives of the participants did not create awareness in these people at a level that would enable them to participate in cancer screening programs and make healthy lifestyle changes.

Evaluation of obstructive sleep apnea prevalence in mothers of infants with low birth weight and its relationship with serum uric acid levels as a hypoxia marker.

OBJECTIVE: Serum uric acid level, which is an oxidative stress marker, may increase in some conditions that lay the ground for the hypoxia. However, recent literature lacks studies with large series on this subject. We aimed to examine the incidence of OSAS in mothers who delivered a low birth weight baby and its association with serum uric acid levels as a hypoxia marker. METHODS: We enrolled 143 pregnant women, 44 of whom delivered a low birth weight (LBW) baby. We made a face-to-face interview in which we asked the questions in the patient follow-up form, comprising three sections. The form included questions regarding the sociodemographic features and obstetric history of the participant women, besides the Berlin Questionnaire and the Epworth Sleepiness Scale. We recorded the blood test parameters that are obtained from patient records in the last section. RESULTS: Mean uric acid (UA) levels of mothers with a LBW baby (n = 44, birth weight below 2500 g) were 4.51 ± 1.23 mg/dL (min-max = 2.7-8.0) while the UA levels in mothers of normal weighted (NBW) babies (n = 99, birth weight is 2500 g or above) were 4.08 ± 0.75 (min-max = 2.6-6.1 mg/dL). The UA levels of mothers who delivered LBW infants were significantly higher compared with the mothers of NBW babies (p = .010). CONCLUSION: Uric acid levels can be used as a prognostic parameter for the closer monitoring of pregnant women who have been diagnosed with small-for-gestational-age babies during pregnancy.

Family physicians' awareness and general knowledge of hidradenitis suppurativa: A survey research.

RATIONALE, AIMS, AND OBJECTIVE: Medical consultations of family physicians play a key role in early diagnosis and proper management of hidradenitis suppurativa (HS). This study aimed to investigate family physicians' disease awareness, general attitudes, and knowledge of HS. MATERIAL-METHODS: This cross-sectional descriptive study was conducted with 211 family physicians and residents through a web-based survey. The questionnaire consisted of 25 questions about the demographic characteristics of the participants as well as their awareness and general knowledge of HS. RESULTS: While 90% of physicians know that the diagnosis of HS is made clinically without any need for a laboratory examination, only 23.7% of them felt confident performing such a diagnosis. About 63% of participants defined HS as an infectious disease of the apocrine glands, contradictive to the real pathophysiology. About 21% of them had not been medically trained in HS, and 3% of them even had never heard the name of HS. Only 33% were aware of the role of biological agents. Most of the family physicians (57.4%) were willing to participate in postgraduate education programmes about HS. CONCLUSION: The family physicians' awareness of HS is limited. Increased practice in medical education and postgraduate education programmes may help increase the knowledge of family physicians.

Influence of single photon emission computed tomography (SPECT) reconstruction algorithm on diagnostic accuracy of parathyroid scintigraphy: Comparison of iterative reconstruction with filtered backprojection.

BACKGROUND & OBJECTIVES: Preoperative localization of parathyroid lesions is essential for improving the results in patients with primary hyperparathyroidism. The purpose of this study was to evaluate retrospectively the value of technetium-99m (Tc-99m) methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) and to compare the diagnostic accuracy of iterative reconstruction (IR) and filtered backprojection (FBP) reconstruction algorithms about localization of parathyroid lesions. METHODS: Forty four patients with primary hyperparathyroidism, in whom histopathological correlation could be performed, were included in the study. Dual-phase Tc-99m parathyroid scintigraphy was performed 20 and 120 min after injection of 740 MBq Tc-99m MIBI in all patients. Tomographic images were acquired 120 min after the administration of radiopharmaceutical. The SPECT data were evaluated using an IR as well as a FBP algorithm. In 23 of 44 patients, SPECT acquisitions were performed in 64×64 matrix; in the remaining 21 patients, tomographic data were collected in 128×128 matrix. The imaging results were compared with pathological findings and sensitivities of both reconstruction algorithms, and planar views were calculated. RESULTS: Using planar MIBI scans, abnormal parathyroid glands were correctly localized in 75 per cent of the cases. Sensitivity increased to 77 per cent using SPECT with FBP and to 84 per cent with IR. When the sensitivities were calculated according to the acquisition matrix, these were 95 per cent (20/21) and 85 per cent (18/21) for IR and FBP, respectively in patients in whom 128×128 matrix was used. The sensitivities were lower in patients who were imaged with 64×64 matrix; these were calculated as 74 per cent (17/23) and 70 per cent (16/23) with IR and FBP, respectively. INTERPRETATION & CONCLUSIONS: Our findings showed that compared to planar scintigraphy, Tc-99m MIBI SPECT was more sensitive diagnostic modality in the detection of abnormal parathyroid tissues. Image quality and sensitivity may be improved further when larger matrices with IR are used instead of FBP algorithm.

General and Disease-specific Scales in Children with Asthma and their Parents.

OBJECTIVE: To investigate and compare the efficiency of general and disease-specific life quality scales in children with asthma. METHODS: Children with asthma, and their parents completed the Childhood Asthma Control Test (C-ACT), Pediatric Asthma Quality of Life Questionnaire (PAQLQ), Pediatric Quality of Life Inventory (PedsQL), and also underwent spirometry. RESULTS: 82 children (55 males) with a median (IQR) age of 10.1 (8.9-10.5) years were included. C-ACT, PAQLQ and PedsQL child scores were significantly higher in children with controlled asthma. CONCLUSION: Quality of life in children, assessed using disease- specific quality of life measures, is better for children with good asthma control.

Fluorodeoxyglucose positron emission tomography/computed tomography findings in a patient with cerebellar mutism after operation in posterior fossa.

Cerebellar mutism is a transient period of speechlessness that evolves after posterior fossa surgery in children. Although direct cerebellar and brain stem injury and supratentorial dysfunction have been implicated in the mediation of mutism, the pathophysiological mechanisms involved in the evolution of this kind of mutism remain unclear. Magnetic resonance imaging revealed dentatothalamocortical tract injuries and single photon emission computed tomography showed cerebellar and cerebral hypoperfusion in patients with cerebellar mutism. However, findings with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in this group of patients have not been documented previously. In this clinical case, we report a patient who experienced cerebellar mutism after undergoing a posterior fossa surgery. Right cerebellar and left frontal lobe hypometabolism was shown using FDG PET/CT. The FDG metabolism of both the cerebellum and the frontal lobe returned to normal levels after the resolution of the mutism symptoms.

Comparison of ambulatory blood pressure measurement with home, office and pharmacy measurements: is arterial blood pressure measured at pharmacy reliable?

RATIONALE, AIMS AND OBJECTIVES: Standardizing arterial blood pressure (BP) measurement is difficult because of different performers like doctor or pharmacy employee. We investigated the reliability between different BP measurement methods. METHODS: The study was conducted in an internal medicine service with 160 patients in Ankara, Turkey. First, the subjects' BP was measured by doctor. Then, 24-hour BP monitoring devices were placed. Participants were then instructed to measure their BPs both at home and in pharmacy. The next day, arterial BP was measured by the doctor for the second time. RESULTS: The prevalence rates of masked and white coat hypertension were 8.8% (n = 14) and 8.1% (n = 13), respectively. There was no statistically significant differences between ambulatory measurement and home, office and pharmacy measurements (P > 0.05). The consistency rate between ambulatory and home measurements was 97.5% (kappa = 0.947, P < 0.001). The consistency rate between ambulatory and pharmacy measurements was 82.5% (kappa = 0.634, P < 0.001). When compared with ambulatory measurement, the most sensitive (98.0%) and most specific (96.8%) method was home measurement. There was a moderate positive correlation between ambulatory and other measurements in both systolic and diastolic values. There was a positive and very strong correlation between ambulatory and home measurements of systolic and diastolic ABP values (respectively; r = 0.926 and r = 0.968) and there was a statistically significant relation between these measurements (P < 0.001). CONCLUSION: The results of all measurement methods were close to each other. The most sensitive and specific method was home measurement when compared with ambulatory measurement. But both office and pharmacy measurements had also high sensitivity and specificity.

Evaluation of obstructive sleep apnea symptoms in pregnant women with chronic disease.

OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) is a disease which is estimated to be undiagnosed to a large extent. Hence, the prevalence of OSAS in pregnant women is unknown. We aimed to evaluate the symptoms of obstructive sleep apnea in pregnant women with chronic diseases. METHODS: In the study, 97 pregnant women with chronic diseases and 160 healthy pregnant women were included. A form questioning socio-demographic characteristics and pregnancy characteristics, Epworth scale and the Berlin questionnaire to evaluate the risk of OSAS were applied to participants. RESULTS: It has been determined that 10-12.5% of healthy pregnant women, 34-45.4% of pregnants with chronic diseases and 20.6-23.3% of all pregnant women had a high risk of OSAS, the pregnants with chronic disease compared to healthy pregnant women had statistically significant higher risk of OSAS. The risk of OSAS was found to be significantly higher especially in pregnant women with hypertension and diabetes. CONCLUSIONS: OSAS can lead to the adverse consequences in pregnancy, should be questioned for all pregnants especially those with chronic diseases. Pregnant women with OSAS should be monitored more carefully in terms of diabetes and hypertension in antenatal care.

Hyoid osteoradionecrosis accompanied by candida infection.

Osteoradionecrosis of the hyoid bone is a rare complication of therapeutic irradiation performed for head and neck cancer. In this article, we present a 52-year-old male patient who admitted with severe odynophagia following chemo-radiotherapy administration for tonsil carcinoma. Fluorine-18-fluorodeoxy-glucose positron emission tomography-computed tomography revealed a metabolic activity in hyoid bone. The pathological findings were consistent with fungal infection and hyoid bone necrosis. Hyoid osteoradionecrosis should be kept in mind in patients with intractable dysphagia following irradiation for head and neck tumors.

Development of a medication adherence scale for familial Mediterranean fever (MASIF) in a cohort of Turkish children.

OBJECTIVES: To develop and assess the validity and reliability of an adherence scale concerning medical treatment in paediatric FMF patients. METHODS: The Medication Adherence Scale in FMF Patients (MASIF) is a 18-item questionnaire that evaluates adherence to medication in four domains. Validation of the instrument was accomplished in paediatric FMF patients (aged 2-18 years) under medication at least for 6 months. The first step was to build up the scale through qualitative approach (with interviews using semi-structured questions). Validation analyses included assessment of feasibility, face and content validity; construct validity, internal consistency and test-retest reliability. RESULTS: One hundred and fifty patients with FMF were enrolled in the study. The mean age of the patients was 11.11±4.02 years and 48.7% of them were male. The MASIF was found to be feasible and valid for both face and content. It correlated with the Morisky Medication Adherence Scale as a gold standard thereby demonstrating good construct validity (r=0.515, p<0.001). Assessment of content validity identified four subscales. The internal consistency, Cronbach's alpha was 0.728. There was a positive and significant correlation between test and retest scores (r=0.843; p<0.001). Also, a significant correlation between parents' and children's reports (r=0.781, p<0.001). CONCLUSIONS: Based on these results, the use of this scale to assess and follow up the adherence to treatment in paediatric FMF patients under medical treatment is recommended.

Pain perception differences between patients and physicians: a pain severity study in patients with low back pain.

AIM: Perception, definition and tolerance of pain vary individually because of its subjective character. This study aimed to determine the perception differences between patients with mechanical low back pain (MLBP) and their physicians regarding the assessments of the patients' pain severity. MATERIAL AND METHODS: 181 patients with MLBP and 2 physicians took part in the study. Before the initial examination, the patients filled out a questionnaire consisting of demographic data, pain characteristics, Modified Oswestry Disability Questionnaire (MODQ) and Visual Analog Scale (VAS). The patients' forms were concealed from the physicians. Then physicians examined their patients and rated their pain severity using a different VAS form. RESULTS: The mean age of the patients was 36.2 ± 12.3 years. 64.6% (n:117) were female, 71.9% (n:13) were highly educated and 57.1% (n:103) were obese. Physicians always rated the patients' pain severity significantly lower than the patients rated their own pain regardless of all demographic data (p < 0.001). Correlation between the VAS scores of patients and physicians were detected as 0.41 (p < 0.001) and the power of the study was calculated as 91.5%. The mean MODQ score of the patients was calculated as 54.4 ± 21.1. Reliability of the questions in MODQ was calculated as alpha:0.87. A moderate correlation between VAS ratings and MODQ was observed (r:0.52, p < 0.001). CONCLUSION: As a main factor directly affecting many outcomes, good communication between patient and physician, is essential to assess the patients' pain more accurately.

Serum Pentraxin-3 Level in Patients Who Underwent Coronary Angiography and Relationship with Coronary Atherosclerosis.

OBJECTIVES: To evaluate the role of pentraxin-3 (PTX-3) in determining the presence and severity of coronary atherosclerosis in patients with coronary artery disease (CAD). SUBJECTS AND METHODS: Ninety-five patients (77 males and 18 females) who underwent elective coronary angiography were enrolled in this study. Patients with heart failure, renal failure, diabetes and thyroid disease were excluded. The study population was divided into 3 groups: individuals with normal coronary arteries, patients with critical CAD (n = 35) and patients with noncritical CAD (n = 36). The association of PTX-3 levels with the presence and severity of CAD and the number of involved vessels were analyzed. RESULTS: The mean age was 53.40 ± 10.25 years. The PTX-3 levels were significantly higher in patients with CAD than without CAD (146.48 ± 48.52 vs. 109.83 ± 49.06 pg/ml, p < 0.001). A statistically significant difference was found among the 3 groups regarding the severity of CAD (165.66 ± 49.10, 127.83 ± 40.51 and 109.83 ± 49.06 pg/ml, p < 0.001, respectively). The serum PTX-3 levels in normal arteries were 110.4 ± 48.11 pg/ml, in single-vessel disease 132.35 ± 32.96 pg/ml, in 2-vessel disease 142.57 ± 55.88 pg/ml, in 3-vessel disease 156.07 ± 50.53 pg/ml, and in 3-vessel disease 160.50 ± 30.41 pg/ml. After adjusting for baseline confounders, older age (OR = 1.107, 95% CI = 1.027-1.193, p = 0.008) and higher PTX-3 levels (OR = 1.017, 95% CI = 1.003-1.032, p = 0.021) were detected as significant predictors for the presence of CAD. CONCLUSIONS: Higher PTX-3 levels were associated with the presence of CAD and its increased severity in clinically stable patients. Higher PTX-3 levels may be regarded as a novel diagnostic predictor and may offer therapeutic options in the clinic.

The Prevalence and Sociodemographic Risk Factors of Enuresis Nocturna among Elementary School-age Children.

INTRODUCTION AND AIM: Many etiological reasons are blamed for enuresis nocturna (EN). The aim of this study was to research prevalence and severity of EN among elementary school-age children and sociodemographic risk factors related to it. MATERIALS AND METHODS: The study was performed in three elementary schools in Ankara, Turkey between January and May 2011. It was planned to have 2500 students of 6-14 ages in the study. The questionnaire, which consisted of questions, aiming to evaluate the EN condition of participants and their characteristics, were distributed to the parents. It was observed that 2314 participants' questionnaires (92.56%) were in accordance with evaluation criteria. STATISTICAL ANALYSIS: The relation between EN and the sociodemographic factors was evaluated through Chi-square test and logistic regression analysis. RESULTS: The mean age of 2314 participants was 9.21 ± 2.08. 48.5% (n = 1123) of the students were male and 51.5% (n = 1191) were female. While the general EN prevalence was 9.9% (n = 230); 10.7% (n = 120) for males, as 9.2% (n = 110) for females. Statistical significant difference was determined between the two groups, with EN and without EN, regarding age groups (P < 0.001), education level of parents (P < 0.001, P < 0.001), and the number of sibling (P = 0.002), income level (P < 0.001), and positive family history (P < 0.001). However, logistic regression analysis revealed that there was a significant difference only between EN and age groups (odds ratio [OR] =4.42, P < 0.001), education level of mother (OR = 2.13, P = 0.017) and family history (OR = 0.12, P < 0.001). CONCLUSIONS: As a consequence, such factors as age groups, education level of parents, positive family history could be accepted as a risk of concerning EN. It is important to perform a detailed evaluation on population, carrying risk of having EN.

Predictors of knowledge level and awareness towards breast cancer among Turkish females.

BACKGROUND: Breast cancer (BC) is the most-common malignancy of women worldwide. Though there are differences among developed and developing countries, BC remains the most common cancer type of women in Turkey. OBJECTIVE: This study aimed to identify the level of knowledge, awareness, and their potential predictors towards BC in Ankara, Turkey. MATERIALS AND METHODS: The present descriptive study was conducted on 376 females attending a breast health outpatient clinic. A self-administered questionnaire was designed to evaluate knowledge level about BC and predictors effecting its level. Data analysis was performed using the chi-square test. A value of p<0.05 was considered statistically significant. RESULTS: Mean age of the participants was 46.2±9.93 (22-75). The majority (92.6 %) were married; 41.5% were educated less than nine years. Most of the women were housewives (82.7%) and, were living in an urban region (86.4%). Predictors of effecting responses to seven knowledge and awareness questions about BC varied from demographic features including older age groups, higher educational levels, being married, living in an urban area, being employee, smoking, having greater BMI to additional attributes associated breast health such as the increased number of births, applying for the purpose of control, positive family history of breast diseases, any diagnoses of breast diseases and performing BSE practice. CONCLUSIONS: It was determined that females in Turkey have better knowledge of BC than other developing countries even though it is not at the desired level. These findings revealed that females should be more informed about BC risk factors, prognosis and treatments by primary health-care providers to counteract the ascending burden of this disease.

Differential diagnosis between secondary and tertiary hyperparathyroidism in a case of a giant-cell and brown tumor containing mass. Findings by (99m)Tc-MDP, (18)F-FDG PET/CT and (99m)Tc-MIBI scans.

Brown tumor is one of the skeletal manifestations of hyperparathyroidism. It is a benign but locally aggressive bone lesion and its differential diagnosis with giant cell containing skeletal tumors or metastases may be complicated. We present a male patient with chronic renal failure who was initially misdiagnosed as having a giant-cell rich neoplasm of bone in his right thumb. Diffusely increased fluorine-18 fluorodeoxyglucose ((18)F-FDG) uptake in the axial and appendicular skeleton and multiple (18)F-FDG avid lytic lesions suggesting multiple metastases were observed on the (18)F-FDG positron emission tomography/computed tomography (PET/CT) scan. On the usual technetium-99m methylene diphosphonate ((99m)Tc-MDP) bone scan we noticed diffusely increased uptake in the skeleton and two focuses with very much increased uptake, which suggested a metabolic bone disease rather than a multiple metastatic giant cell tumor or bone metastases. Additional investigation documentated increased levels of parathyroid hormone. Parathyroid hyperplasia was finally diagnosed with (99m)Tc-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy. Fluorine-18-FDG avid lytic lesions were attributed to hyerparathyroidism associated brown tumors instead of multiple metastases. In conclusion, we present a patient with chronic renal insufficiency, who suffered from secondary and later from tertiary HPT with polyostotic brown tumors, which were best shown by the (18)F-FDG PET/CT than by the (99m)Tc-MDP or the (99m)Tc-MIBI scans.