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Objectives: This study aimed to evaluate the frequency of fibromyalgianess, fibromyalgia syndrome (FS), and widespread pain in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and their relationship with clinical and demographic parameters. Patients and methods: This cross-sectional multicenter trial was performed in 14 centers across Türkiye between June 2018 and November 2019. Out of 685 patients recruited from the accessible population, 661 patients (342 RA, 319 AS; 264 males, 397 females; mean age: 48.1±12.9 years; range, 17 to 88 years) met the selection criteria. In these cohorts, those who did not meet the criteria for FS and had widespread pain (widespread pain index =7) were evaluated as a separate group. Clinical status and demographic parameters of patients in both cohorts were evaluated as well as the evaluations of RA and AS patients with widespread pain (widespread pain index =7) and RA and AS patients with FS groups. In addition, correlations between polysymptomatic distress scale (PSD) scores and Visual Analog Scale (VAS), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), and Disease Activity Score using 28 joint counts for RA patients and VAS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Ankylosing Spondylitis Disease Activity Score (ASDAS) for AS patients were analyzed. Results: Frequencies of patients with FS and patients who had PSD scores =12 were 34.1% and 44.4% in all RA patients, respectively. Moreover, FS and PSD scores =12 were found in 29.2% and 36.9% of all AS patients, respectively. PSD scores of RA patients with FS were higher than all RA patients and RA patients with widespread pain. SDAI and CDAI scores of RA patients with FS were higher than all RA patients and RA patients with widespread pain. Similarly, PSD scores of AS patients with FS were higher than all AS patients and AS patients with widespread pain. ASDAS-erythrocyte sedimentation rate and BASDAI scores of AS patients with FS were found higher than all AS patients and AS patients with widespread pain. Conclusion: Disease activity scores, including pain in RA and AS, were higher in the presence of FS or fibromyalgianess. It may be related to clinical parameters, but cohort studies with long-term follow-up are needed to reveal causality. Additionally, to avoid overtreatment, coexistence of fibromyalgianess should be kept in mind in patients who have inflammatory diseases such as RA and AS, particularly with intractable widespread pain. [ABSTRACT FROM AUTHOR]

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the health status, experiences, and status of contracting or being affected poorly by coronavirus disease-2019 (COVID-19) in patients using disease-modifying antirheumatic drugs (DMARD). Methods: Patients using DMARD for rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis registered in our rheumatic diseases outpatient clinic were assessed during their routine follow-up control between July 2020 and January 2021. Their health status between March and June 2020 was also registered in the first evaluation. A follow-up form was used in which demographic data, systemic diseases and drugs, rheumatic diseases and treatments, and changes in treatment and complaints during the pandemic period were questioned. Results: One hundred fifty six (95 female, 61 male) patients were included in the study, the mean age was 43.4. There was no relationship between age, gender, body mass index, occupation, rheumatic disease group, and DMARD groups, with conditions of getting or being affected severely by COVID-19. Statistically significant relationships were found between having a chronic respiratory disease or having more than one comorbid disease and severe COVID-19 outcomes and between having moderate/high rheumatic disease activity and contracting COVID-19 (p<0.05 for all). The rate of getting COVID-19 in smokers was significantly lower than in non-smokers (p=0.039). There was a significant increase in disease activity during the pandemic period compared with the pre-pandemic period (p<0.001). A statistically significant relationship was found between making changes for treating rheumatic disease and an increase in disease activity (p=0.003). Conclusion: Those with multiple comorbid diseases have an increased risk of severe COVID-19, and those with moderate- tohigh disease activity have an increased risk of developing COVID-19. The decrease in compliance with routine follow-up and drug treatment during the pandemic increases the risk of increased rheumatic disease activity. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the effects of novel coronavirus disease 2019 (COVID-19) vaccines administered in Türkiye on disease activity and the side effects in the patients with inflammatory rheumatic disease (IRD). Patients and methods: Between September 2021 and February 2022, a total of 536 patients with IRD (225 males, 311 females; mean age: 50.5±12.6 years; range, 18 to 93 years) who were vaccinated against COVID-19 and followed in the outpatient setting were included in the study. Vaccination status of the patients and whether they had COVID-19 were questioned. All patients were asked to rate their anxiety about the vaccination on a scale of 0-10 before and after the shots. They were asked whether they experienced any side effects and an increase in IRD complaints after vaccination. Results: A total of 128 (23.9%) patients were diagnosed with COVID-19 before the first vaccination. Totally, 180 (33.6%) patients were vaccinated with CoronaVac (Sinovac) and 214 (39.9%) patients with BNT162b2 (Pfizer-BioNTech). Also, 142 (26.5%) patients were given both vaccines. When the anxiety level of the patients before the first vaccination was questioned, 53.4% reported that they had no anxiety. The rate of patients without any anxiety after vaccination was 67.9%. Comparison of pre- (median Q3=6) and post-vaccine (median Q3=1) anxiety values showed a statistically significant difference (p<0.001). A total of 283 (52.8%) patients reported side effects after vaccination. When both vaccines were compared with each other, the rate of the side effects was higher in the BNT162b2 group (p<0.001) and also in the CoronaVac plus BNT162b2 group (p=0.022). There was no statistically significant difference between BNT162b2 and CoronaVac plus BNT162b2 in terms of side effects (p=0.066). Forty-five (8.4%) patients had increased rheumatic complaints after vaccination. Conclusion: The lack of a significant increase in disease activity after COVID-19 vaccination in patients with IRD and the absence of serious side effects requiring hospitalization support the safety of vaccines in this patient group. [ABSTRACT FROM AUTHOR]

Local glucocorticoid injections are used in the treatment of isolated sacroiliitis in patients with spondyloarthritis. Sacroiliac joint injections can be performed intraarticularly or periarticularly. Since the accuracy of blind injections is low, fluoroscopy, magnetic resonance imaging, computed tomography, or ultrasonography guidance are used to increase the accuracy of sacroiliac joint injections. Currently, imaging fusion software is successfully used in sacroiliac joint interventions with three-dimensional anatomic information added to ultrasonography. Herein, we present two cases of sacroiliac joint corticosteroid injections under ultrasonography-magnetic resonance imaging fusion guidance. [ABSTRACT FROM AUTHOR]

Psoriatic arthritis is a chronic systemic inflammatory disease characterized by joint inflammation associated with psoriasis and may present with a variety of clinical manifestations related to bone structures and soft tissues around the joints. Psoriatic arthritis may show radiological findings similar to osteomyelitis (OM). A 69-year-old patient who had been diagnosed with psoriatic arthritis for 5 years was referred to our clinic with a preliminary diagnosis of OM due to severe pain in the right elbow. The patient had polyarthralgia and extensive skin involvement. Disease activation was considered as a result of detailed investigations. Both the joint and skin involvement of the patient was controlled with biological agent treatment. Differential diagnosis should be done carefully in patients with arthralgia and/or arthritis. Advanced radiological imaging should be performed. [ABSTRACT FROM AUTHOR]

Pectoralis minor syndrome (PMS) is defined as compression of the brachial plexus (BP) nerves, axillary artery, and axillary vein under the pectoralis minor muscle. The symptoms of PMS resemble supraclavicular compression of the neurovascular bundle, with shoulder, neck, chest, and arm pain, and paresthesia and weakness in the arm and hand. The diagnosis of PMS can be confused with other upper extremity pain syndromes. A detailed history, including occupation, daily activities, sports, and trauma, is critical in the diagnosis, together with physical examination findings. Radiological examinations, including direct radiography, computed tomography, magnetic resonance imaging, and electrophysiological tests, are also helpful for the differential diagnosis. Arterial and venous Doppler ultrasound, including dynamic investigation, can display arterial and venous compression. Injection tests are used to confirm the definitive diagnosis. Conservative treatment is successful in most patients, and surgical treatment is considered in unresponsive cases. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The aim of this study was to assess the effects of spasticity on glucose metabolism and percentage of fat-free mass (FFM%) in patients with spinal cord injury (SCI). Patients and methods: A total of 33 patients (22 males, 11 females; mean age: 38.6±12.5 years; range, 20 to 64 years) with SCI defined by the American Spinal Injury Association Impairment Scale Grades A to D were included between September 2014 and May 2018. We assessed spasticity with the Modified Ashworth Scale (MAS) and evaluated spasms with the Penn Spasm Frequency Scale (PSFS). We assessed the glucose metabolism by calculating the Matsuda and HOMA-IR index, and measured FFM% by dual-energy X-ray absorptiometry. Results: Fourteen patients had motor complete, and 19 had motor incomplete SCI. The neurological injury levels of the patients were C4-T12. There was a positive correlation between hip adductor muscle MAS and trunk, android, and gynoid FFM% and between hip extensor muscle MAS and android FFM% in patients with motor complete SCI. Hip extensor and knee flexor muscle MAS showed a negative correlation with the HOMA-IR. Hip adductor and extensor muscle MAS, as well as knee flexor and extensor muscle MAS, had a positive correlation with the Matsuda index in these patients. There was a positive correlation between knee extensor muscle MAS and gynoid FFM% and between PSFS and arms, trunk, gynoid, and total FFM% in patients with motor incomplete SCI. There was a negative correlation between hip adductor and extensor muscle MAS, PSFS, and level of fasting glucose in these patients. Conclusion: This study supports the notion that spasticity has positive effects on the FFM% and glucose metabolism in patients with motor complete and incomplete SCI. [ABSTRACT FROM AUTHOR]

Thoracic outlet syndrome is characterized by pain, paresthesia, muscle weakness, and arterial/venous symptoms caused by compression of the neurovascular structures. Compression mainly occurs at three distinct areas in the thoracic outlet: the retropectoralis minor space, the costoclavicular space, and the interscalene triangle. As the symptoms of these three compression sites are very similar, it is difficult to pinpoint the location of the compression and the treatment methods are quite different. Ultrasound-guided diagnostic injections play an important role in the differential diagnosis. Herein, we report a 49-year-old female patient who was previously diagnosed with thoracic outlet syndrome and scheduled for decompression of cervical ribs, but cured by conservative methods after being diagnosed with pectoralis minor syndrome. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we aimed to evaluate the efficacy of kinesiotaping (KT) in patients with chronic non-specific neck pain (NSNP) in terms of pain, disability, cervical range of motion (ROM), and cervical lordosis. Patients and methods: Between October 2013 and March 2014, a total of 50 patients (10 males, 40 females; mean age 35.1±9.9 years; range, 17 to 62 years) with chronic NSNP were randomized into the KT (n=25) or the sham KT intervention (n=25) groups. Both groups were additionally given a therapeutic exercise (TE) program. The Visual Analog Scale (VAS) and Neck Disability Index (NDI) scores and ROM measurements were recorded at baseline, at the end of treatment, and at one month. Lateral cervical digital radiographs were analyzed by the Cobb, posterior tangent and effective lordosis methods at baseline and at one month after the treatment. Results: There was a statistically significant decrease in the VAS scores compared to baseline in the KT group. The NDI scores significantly decreased in both groups. The patients in the KT group experienced a significant increase in all planes of cervical ROM after the treatment. Cervical radiographs revealed a significant increase in the Cobb and posterior tangent angles only in the KT group. Conclusion: Our study results suggest that KT significantly improves VAS, NDI scores, ROM and cervical lordosis angles. The combination of TE and KT is useful in reducing pain and disability and improving ROM and cervical lordosis loss in patients with chronic NSNP. [ABSTRACT FROM AUTHOR]

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Osteoporosis / Turk Osteoporoz Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pregnancy and lactation-associated osteoporosis (PLO) is a rare condition. Its pathogenesis and etiology are unknown. It is frequently observed in the last trimester of pregnancy and during lactation period in primigravida. The symptoms may begin with back and hip pain. In addition, it could be complicated by osteoporotic fractures and disability. Here, we report a long-term (7 years) follow-up of a 29-year-old patient who underwent two pregnancies and was diagnosed with PLO both the times. The first time this patient was admitted to our outpatient clinic with a complaint of severe back pain, she was in the lactation period of her first pregnancy. Laboratory findings, X-ray imaging and densitometry revealed osteomalacia (25-OH Vit D = 6.8 ng/dL), multiple vertebral fractures (T6-T9-T11-T12-L1), and osteoporosis (L1-L4 T-score: -4.6). After the treatment for vitamin D deficiency, she was treated with risedronate and Ca-vitamin D supplementation. At the end of the 2-year follow-up, she terminated the use of risedronate [by her own decision] and continued with the Ca-vitamin D supplementation. Six years after the first pregnancy, she became pregnant again. In the postpartum period, she complained about gait difficulty, and severe hip and back pain. With the help of laboratory results, imaging, and densitometry (L1-L4 T-score: -3.9), she was diagnosed with PLO second time, and was treated with zoledronic acid, in addition to Ca-vitamin D supplementation. Once back pain occurs in the postpartum period, PLO should be considered in differential diagnosis even if the patient is taking Ca-vitamin D supplementation. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Osteoporosis / Turk Osteoporoz Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi is the property of Turkish Society of Physical Medicine & Rehabilitation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi is the property of Turkish Society of Physical Medicine & Rehabilitation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Southern Clinics of Istanbul Eurasia is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Osteoporosis / Turk Osteoporoz Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cervical spondylotic myelopathy is the most important cause of myelopathy in the elderly. It is defined as spinal cord dysfunction secondary to the compression of the cord caused by degenerative disease of the cervical spine. Cervical spondylotic myelopathy is a slowly progressing disease and disability caused by cervical spondylotic myelopathy can be life threatening. Despite its severity, it may remain undiagnosed for a long time. We report the case of an 80-year-old female with cervical spondylotic myelopathy leading to paraparesis. She progressively had difficulty in walking, which worsened in the last year. She had knee pain for several years, with a known diagnosis of bilateral gonarthrosis. She had been walking with the aid of a cane when her symptoms worsened and became unable to walk independently in the past months. Her walking disability was attributed to advanced bilateral gonarthrosis. Upon physical examination, she had bilateral knee contractures, extensor plantar responses, and tonus was slightly increased in the legs. Muscle strength was also decreased in the right upper and bilateral lower extremities. Magnetic resonance imaging of the cervical spine revealed spondylotic myelopathy from C3 to C6. Cervical decompression and a stabilization operation were performed. She responded well to the rehabilitation programme. Cervical spondylotic myelopathy should always be considered for elderly patients with walking disabilities, and physicians should be aware that this disease develops insidiously and coexisting diseases leading to disability may mask the symptoms and delay the diagnosis. [ABSTRACT FROM AUTHOR]

Objective: There is ongoing controversy related to the relationship between bisphosphonates and atrial fibrillation (AF). Our aim in this study was to evaluate the potential acute effect of zoledronic acid (ZA) infusion on AF development by using 24-hour Holter recordings. Methods: The study was designed to be a self-controlled case series study, and 33 consecutive patients with osteoporosis (29 females, age: 62.3±9.0 years) who were scheduled to receive ZA infusion constituted the study population. Patients underwent 24-hour Holter rhythm recordings at two different times; the first one was 48 hours before the planned ZA infusion, and the second one was on the morning of the infusion day. Heart rate, frequency and type of arrhythmias, as well as heart rate variability (HRV) from the two recordings were compared. Results: There were no episodes of AF greater than 30 sec in any of the 24-hour Holter recordings obtained before and on the day of drug infusion. Holter recordings before drug infusion showed that only 1 patient had an atrial run of 3 beats long. Holter recordings obtained on the day of drug infusion revealed that 5 patients (15.2%) had atrial runs with lengths ranging between 3 and 12 beats (p=0.046). Regarding HRV variables, SDANN values were found to be significantly depressed on the day of ZA infusion (113.6±26.9 vs. 98.2±29.9, p=0.007). Conclusion: None of the patients developed AF during or early after ZA infusion. However, there was an increase in atrial ectopy in some patients, which might be due to alterations in cardiac autonomic activity. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis causes bones to lose their resilience, increases fragility and results in bone fracture even with minimal trauma during daily activities. We aimed to examine the patients who were treated for atypical fractures in terms of long-term bisphosphonate usage for the treatment of osteoporosis. Materials and Method: A retrospective study was conducted on 21 patients who underwent surgery for an atypical femur fracture between years 2007-2013. Demographic data, history of bisphosphonate treatment, trauma type, patient complaints prior to fracture, fracture type and the type of treatment used for the fracture were assessed. Results: The number of cases with atypical fractures was 21 and all of them had history of prolonged bisphosphonate use. The number of female patients was 19, and 2 patients were male, with an average age of 76.4 years. The number of patients with diaphyseal femur fractures was 17 and 4 patients had subtrochanteric femur fractures. Among the patients that have been using a bisphosphonate, alendronate (70 mg) was the most frequently used medication. The average length of bisphosphonate usage was 8.1 years and the average length of time that elapsed until a fracture occurred subsequent to the start of drug usage was 7.2 years. Prior to fracture, all of the patients had complaints of thigh pain that lasted on average for 8.5 months. Conclusion: Bisphosphonates are one of the widely used agents used in the treatment of osteoporosis. Thigh pain in patients with prolonged bisphosphonate usage should alarm the physicians for possible atypical fracture in the future. [ABSTRACT FROM AUTHOR]

Relapsing seronegative symmetrical synovitis with pitting edema (RS3PE) is a clinical syndrome characterized by acute onset of symmetrical joint involvement with pitting edema of the hands and feet. The etiology and pathogenesis of RS3PE is still unknown, though environmental and infectious agents may play a role in its development. RS3PE might be associated with rheumatologic diseases; while coexistence of RS3PE with neoplasms is also reported. Prognosis of RS3PE is good, with high response to low dose corticosteroids. A 72 year old man, who also suffers from prostate adenocarcinoma, with RS3PE syndrome is reported. He had no symptoms of prostatism or systemic symptoms. Adenocarcinoma was detected during the investigation for a possible coexisting malignancy. He responded well to the steroid treatment. Aged patients diagnosed with RS3PE syndrome should be carefully investigated for coexistence with neoplasms and followed for a future malignant process. Low dose corticosteroids should be initiated in all patients, together with the appropriate treatment for the malignancy in patients with neoplastic RS3PE. [ABSTRACT FROM AUTHOR]

Amaç: Omuz ağrısı ile başvuran hastalarda ağrının büyük bölümü subakromial bölgedeki bursa patolojilerinden kaynaklanır. Derin yerleşimli olanlarda bursit düşündürecek fizik muayene bulgusu elde edilemez. Bu hastalarda ultrason hem tanı konulması hem de bu bölgeye yapılacak girişimlere klavuzluk etmesi açısından önemlidir. Bu olguda subdeltoid bursa içinde kalsifik bursiti olan hastanın kalsifik lezyonun parçalanarak bursa içine lavaj yapılması ve sonrasında steroid enjeksiyonu yapılarak başarılı bir şekilde tedavisinden bahseûnekteyiz. Olgu: 63 yaşında kadın hasta 3 ay önce sağ omuzda başüstü hareketlerde ağn ile dış merkeze başvurmuş,yapılan omuz MR'da im-pingement bulgulan saptanmılştı. Fizik tedavi programından fayda görmemesi üzerine kliniğimize başvurdu. Fizik muayenede omuzda şişlik, kızarıklık, sıcaklık artışı yoktu, omuz fleksiyonu ve iç rotasyonu kısıtlıydı. Bilinen sistemik hastalık öyküsü ve ilaç kullanımı olmayan hastanın tetkiklerinde akut faz reaktanları (sedi-mentasyon, CRP), ürik asit, kalsiyum, fosfat, tam kan, böbrek fonksiyon testleri, TSFI ve parathormoıı düzeyleri normaldi. Otoantikorları (RF, CCP) negatifti. Omuz direkt grafisi normaldi. Yapılan omuz USG'de subdeltoid bursada efiizyon, büyük bir kalsifik lezyon ve power doppler sinyal artışı izlendi (Şekil PS-190). USG eşliğinde bursa içindeki efiizyon boşaltıldı, kalsifik lezyon iğne (21 gauge) ile parçalandı, lokal anestezik (%2'lik lidoka-in 2 cc) ve serum fizyolojik (2 cc) ile bursa doldurulup tekrar lavaj yapıldı, takibinde bursa içine steroid (betametazone 1 anıp) enjek-siyonu uygulandı. 1 hafta sonraki kontrolünde hastanın ağrısı ve hareket kısıtlığı tamamen düzeldi, tekrarlanan USG de kalsifik lezyonun ve bursitin tamamen gerilediği görüldü. Sonuç: Kalsifik bursit sıklıkla subacromial ve trokanterik bur-sada izlenmektedir. Kalsifikasyonda ilk birikim sert formda olmaktadır. Takibinde inflamatuar rezorptif faz ile kalsifikasyon parçalanır ya da yumuşar. Bu dönemde şiddetli] ağrıya yol açabilir. Büyük çamursu kalsifikasyonlar ve bursal kalsifikasyonlar ultrasonografi ile çok daha iyi saptanır, küçük ve dağınık depo-zitlerin ise direkt grafide görülme oranı daha yüksektir. Bursa, tendon gibi yapılarda kalsifik lezyonlar her zaman direkt grafide bulgu vermez. Bu hastalarda ultrason görüntülemesi oldukça değerlidir. Semptomatik olan hastalarda ultrason eşliğinde lezyonun iğne ile parçalanması, lokal anestezik ve serum fizyolojikle lavajı ve steroid enjeksiyonu ile çok kısa sürede komplet iyileşme sağlanabilmektedir. [ABSTRACT FROM AUTHOR]

Introduction. Nontyphoidal salmonellosis causes significant morbidity, is transmitted via fecal-oral route, and is a worldwide cause of gastroenteritis, bacteremia, and local infections. Salmonella is a less common etiologic factor for septic arthritis compared with other gram-negative bacteria. Cases. We present two septic arthritis cases with Salmonella enteridis as a confirmed pathogen and also discuss the predisposing factors and treatment. Discussion. Septic arthritis is an orthopedic emergency. The gold standard treatment of septic arthritis is joint debridement, antibiotic therapy according to the culture results, and physiotherapy, which should start in the early postoperative period to prevent limitation of motion. Salmonella is an atypical agent for septic arthritis. It must be particularly kept in mind as an etiologic factor for the acute arthritis of a patient with sickle cell anemia and systemic lupus erythematosus. Clinicians should be cautious that the white blood cell count in synovial fluid can be under 50.000/mm3 in immune compromised individuals with septic arthritis. The inflammatory response can be deficient, or the microorganism may be atypical. Conclusion. Atypical bacteria such as Salmonella species in immune compromised patients can cause joint infections. Therefore, Salmonella species must always be kept in mind for the differential diagnosis of septic arthritis in a clinically relevant setting. [ABSTRACT FROM AUTHOR]

Aneurysmal bone cyst of the spine can rarely cause acute paraplegia in young patients. A 30-year-old male patient presented to our physical medicine and rehabilitation outpatient clinic with back pain and bilateral lower extremity weakness for 2 weeks. The patient had no history of trauma. In magnetic resonance imaging, the cystic lesions were determined which destructive, contain internal septations and have multiple fluid-fluid levels at the T5-T6 level. The aneurysmal bone cyst was shown by histopathology. Complete resection to the cystic lesion and posterior segmental instrumentation at T2-T7 level were performed. In the control examination performed 6 months later, lower extremity muscle strength was complete and no recurrence was detected. [ABSTRACT FROM AUTHOR]

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Background: Meralgia paresthetica (MP) is an entrapment mononeuropathy of the lateral femoral cutaneous nerve (LFCN), in which conservative treatment options are not always sufficient., Objectives: The aim of this study was to evaluate the efficacy of ultrasound (US)-guided LFCN injection in the management of MP by comparing with transcutaneous electrical nerve stimulation (TENS) therapy and sham TENS therapy., Study Design: A prospective, randomized, sham-controlled study., Setting: Health Sciences University Training and Research Hospital in Turkey., Methods: Patients diagnosed with LFCN compression with clinical and electrophysiological findings were included in this study. Patients were randomly assigned to 3 groups: (1) US-guided injection group, (2) TENS group, and (3) sham TENS group. The blockage of the LFCN was performed for therapeutic MP management in group 1. Ten sessions of conventional TENS were administered to each patient 5 days per week for 2 weeks, for 20 minutes per daily session in group 2, and sham TENS was applied to group 3 with the same protocol. Visual Analog Scale (VAS), painDETECT questionnaire, Semmes-Weinstein monofilament test (SWMt), Pittsburgh Sleep Quality Index (PSQI), and health-related quality of life (36-Item Short Form Health Survey [SF-36]) at onset (T1), 15 days after treatment (T2), and 1 month after treatment (T3) were used for evaluation. Patients and the investigator who evaluated the results were blinded to the treatment protocol during the study period., Results: A total of 54 of the 62 patients (group 1 n = 17, group 2 n = 16, group 3 n = 21) completed the study, 3 patients from group 1, 4 patients from group 2, and 1 patient from group 3 dropped out during the follow-up period. The mean changes in painDETECT and SWMt scores showed a statistically significant difference between groups in favor of group 1 at T2 and T3 compared with T1 (P < 0.05). There was no statistically significant difference between groups in terms of VAS, SF-36, and PSQI scores (P > 0.05). In-group analysis of VAS scores showed a statistically significant decrease in T2 and T3 compared with T1 in group 1 (P < 0.05). In-group analysis of the VAS scores statistically significant decrease was shown in T2 compared with T1 in group 2 (P < 0.05). In-group analysis of painDETECT scores statistically significant decrease was shown in T2 and T3 compared with T1 in all groups (P < 0.05). In-group analysis of SWMt scores statistically significant decrease was shown in T2 and T3 compared with T1 in group 1 (P < 0.05). In-group analysis of SF-36 and PSQI scores, there was no statistically significant decrease in all groups (P > 0.05)., Limitations: The limitation of the study was a short follow-up period., Conclusions: US-guided LFCN injection and TENS may be therapeutic options for MP treatment, however, for patients with neuropathic pain symptoms, US-guided LFCN injection may be a safe and alternative method to conservative treatment., Key Words: Meralgia paresthetica, ultrasound-guided injection, transcutaneous electrical nerve stimulation.

Objectives: This study aims to assess and compare the efficacy of subacromial tenoxicam and steroid injections in treating patients with shoulder impingement syndrome., Patients and Methods: Forty patients having shoulder impingement syndrome with findings of rotator cuff tendinitis or subacromial bursitis on magnetic resonance imaging were included in the study. Patients were randomized into two subacromial injection groups: patients in the first group (10 males, 10 females; mean age 45.3 years; range 32 to 67 years) were administered 20 mg tenoxicam three times by weekly intervals, and patients in the second group (8 males, 12 females; mean age 46.5 years; range 29 to 73 years) were administered 40 mg methylprednisolone acetate just for once. Visual analog scale (VAS), active range of motion (ROM) of the shoulder joint, and Disabilities of Arm, Shoulder and Hand (DASH) questionnaire scores were evaluated at baseline, six weeks after treatment, and first year., Results: Visual analog scale, DASH, and active ROM scores in both groups were statistically significantly improved. No statistically significant difference was detected between subacromial tenoxicam and steroid injections in terms of post-treatment VAS, DASH, and active ROM scores. Mean pre- and post-treatment VAS scores in tenoxicam group were 7.8 (range, 3-9) and 2.6 (range, 2-4), respectively. Mean pre- and post-treatment VAS scores in steroid group were 6.2 (range, 3-10) and 3.6 (range, 0-7), respectively. Mean pre- and post-treatment DASH scores in tenoxicam group were 59.4 (range, 45-80) and 14.7 (range, 8.3-25.8), respectively. Mean pre- and post-treatment DASH scores in steroid group were 56.7 (range, 33.3-85.8) and 18.1 (range, 0-69.2), respectively. Although the improvement in active ROM was higher in the steroid group, difference between two groups was not statistically significant., Conclusion: Both subacromial tenoxicam and steroid injections may be successfully used in the treatment of patients with impingement syndrome. Subacromial tenoxicam injection may be preferred as a first-line intervention in these patients thanks to its safe profile.

Background/aim: A randomized, placebo-controlled, double-blind study was designed to investigate the effectiveness of ultrasound therapy in primary knee osteoarthritis., Materials and Methods: Ninety patients between 40 and 65 years of age having grade 2 and 3 bilateral knee osteoarthritis enrolled in the study were randomly assigned into 3 groups: continuous ultrasound, pulsed ultrasound, and placebo ultrasound. All patients were given a home exercise program. Patients were evaluated at baseline, at the end of the treatment, and at the second month after the treatment by a range of motion measurement, visual analog scale, Lequesne index for knee osteoarthritis, and Short Form-36 quality of life scale., Results: The increase in the knee range of motion was similar in both ultrasound groups, while the change in the placebo group was not statistically significant. Visual analog scale scores and Lequesne scores of the placebo group at the second month were significantly greater than both ultrasound groups' scores (P < 0.01 and P < 0.05, respectively)., Conclusion: Significant improvements in terms of pain, function, and quality of life scales were noted in both ultrasound groups in comparison with the placebo group. No statistically significant difference was found in terms of efficacy between the continuous and pulsed ultrasound.