Effects of Adding Whole-Body Vibration to Routine Exercise Therapy on Pain, Disability, Muscle Strength, and Endurance in Individuals With Chronic Nonspecific Neck Pain: A Randomized Controlled Trial.

Primary hyperparathyroidism is a prevalent endocrine disorder marked by the autonomous overproduction of parathyroid hormone, which results in a chronic disruption of the calcium and phosphate balance. The underlying cause of 80%-85% of cases is a single parathyroid adenoma, followed by multiglandular hyperplasia and, much less commonly, parathyroid carcinoma. Fine-needle aspiration (FNA), especially when combined with PTH washout, is primarily used to confirm that a lesion is of parathyroid origin and consistent with a parathyroid adenoma. The parathyroid adenoma in our patient was clearly identified by the SPECT/CT scan, and the diagnosis was confirmed by the laboratory findings, which showed increased PTH and calcium. Because both imaging and biochemical data were convincing, FNA was not essential in this case. Excess PTH promotes increased intestinal calcium absorption, renal calcium reabsorption, and bone resorption by boosting the synthesis of 1,25-dihydroxyvitamin D. These processes ultimately lead to skeletal demineralization, hypercalcemia, and hypophosphatemia. Although routine serum calcium testing was historically associated with symptoms such as nephrolithiasis, osteoporosis, bone pain, muscle weakness, gastrointestinal complaints, and neuropsychiatric disorders, its widespread use has shifted the clinical profile toward asymptomatic or mildly symptomatic presentations, particularly in developed countries.