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Objective: This study aims to compare the effectiveness of laser and extracorporeal shockwave therapy (ESWT) in patients with myofascial pain syndrome (MPS). Methods: Forty patients included in this prospective randomized study were divided into 2 groups. Stretching and posture exercises and 15 sessions of laser therapy were applied to the first group. Stretching/posture exercises and 3 sessions of ESWT were applied to the second group. The patients were evaluated before (BT), after (AT), and in the first month (T1) of treatment. Demographic data, the Visual Analogue Scale (VAS), the pressure pain threshold (PPT), the Short Form-36 (SF-36), and the Beck Depression Inventory (BDI) were recorded. Results: A total of 40 patients, 20 in the laser group and 20 in the ESWT group, were included in this study. The patients' mean age was 35.3 ± 11.2. There was no statistically significant difference found between the groups in demographic data (P > .05). Both groups showed a statistically significant decrease in VAS scores. There is improvement in T1 in both groups in the evaluations in the PPT. The BDI and SF-36 physical component values of the patients showed improvement in both groups in BT-T1, but no statistical difference was found in the SF-36 mental tab in BT-AT. No statistical difference was found between the groups in all values. Conclusion: This study showed that laser and ESWT treatments provided significant improvement in MPS. However, the efficacy of these 2 treatments combined with exercise in MPS is similar, and no superiority has been found. [ABSTRACT FROM AUTHOR]

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]

Objectives: This study aims to evaluate the efficacy and safety of thiocolchicoside (TCC) ointment treatment compared to placebo in patients with chronic mechanical low back pain (LBP) accompanied by acute muscle spasms. Patients and methods: A total of 292 adult patients (106 males, 186 females; mean age: 38.5±11.2 years; range, 18 to 64 years) were randomized to TCC group (n=147) and placebo group (n=145) in 12 centers between March 2020 and March 2021. Eight patients from each group were excluded from the analysis. The primary endpoint was pressure pain threshold (PPT) on Day 3, which was measured using a pressure algometer. Secondary endpoints were PPT on Day 7, patient, and physician Visual Analog Scales-pain (VAS-pain) on Days 3 and 7, and safety. Results: The PPT values on Day 3 was not significantly different between the treatment groups (p=0.701). Similarly, TCC and placebo group had similar VAS-pain scores over trial period (p=0.577 or higher for comparisons). Significantly higher PPT values and lower VAS-pain scores on Days 3 and 7 were observed in both groups (p<0.001 for all). In patients with a PPT value of =3.87, TCC arm had higher PPT on Day 3 compared to placebo (p=0.029). Three patients (two in the TCC arm and one in the placebo arm) discontinued the trial due to an adverse event. Conclusion: Topical TCC can be an appropriate option in a subset of patients with mild chronic LBP accompanied by muscle spasms. In a subset of patients with milder pain intensity, topical TCC may improve pain earlier. The results of this trial are compatible with the treatment approaches used in daily practice. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to compare the effectiveness of dry needling (DN) and kinesiotaping (KT) therapies on pain, quality of life, depression, and physical function in the treatment of myofascial pain syndrome (MPS). Patients and methods: The study included a total of 60 patients (4 males, 56 females; mean age 31.2±9.8 years; range, 18 to 56 years) diagnosed with MPS between January 2014 and June 2014. The patients were randomly divided into two treatment groups: the DN group (n=30) and KT group (n=30). Both groups performed stretching and postural exercises. The scales used for measurements were the Visual Analog Scale (VAS) for pain, a pressure algometer for the pressure-pain threshold, the Short Form-36 (SF-36) for the quality of life, Beck Depression Inventory (BDI) for depression, and the Neck Pain and Disability Scale (NPDS) for physical function. The patients were evaluated by a single assessor three times: pre-treatment, at the end of the treatment, and two months after the treatment. Results: Both DN and KT provided significant improvements for all baseline measurements (VAS, pressure pain threshold, all subscales of SF-36, BDI, and NPDS scores) at the end of the treatment and two months after the treatment (p<0.05). However, there was no significant difference between the groups in all measurements (p>0.05). Conclusion: Kinesiotaping is as an effective method as DN in the treatment of MPS. It can be served as a non-invasive alternative to patients with needle phobia. [ABSTRACT FROM AUTHOR]

Amaç: Romatoid artrit (RA) toplumda en sık görülen, otoim-mün ve inflamatuar hastalıktır. En sık kronik iltihabi eklem hastalığı kliniğiyle birlikte olması yanında eklem dışı tutulundan da olan sistemik bir hastalıktır. RA'nın en sık görülen eklem dışı tutulumu plöropulmoner mtulumdur. RA'lı hastalarda pul-moner enfeksiyon ve ilaç toksisitesi sık görülmekle birlikte ro-matoid artritin primer sorumlu olduğu akeiğer parenkim, hava yolu ve plevra hastalıkları oldukça yaygın olarak saptanmaktadır. RA'da plöropulmoner tutulum genellikle eklem bulgularından sonra görülmesine rağmen nadiren başlangıç bulgusu da olabilir, bu durum ayırıeı tamda yanılgıya neden olabilir . Bu sunumda plöropulmoner hastalık semptomları ile başvuran, akciğerinde romatoid nodül ve buzlu cam görünümü saptanarak RA tanısı alan olgumuzu sunmak istedik. Olgu: 51 yaşında erkek hasta nefes darlığı, göğüs ağrısı nedeniyle başvurduğu göğüs hastalıkları kliniğinden tarafımıza akciğer alt loblarda retikülonodüler görünüm ve sağ orta lobda saptanan subplevral 8 mm'lik 2 adet nodül (Şekil PS-228) nedeniyle roma-tolojik etyoloji açısından konsülte edildi. Hastanın romatizmal sorgusunda ara ara olan el bileklerinde günlük yaşammı hafif etkileyen şişlik ve ağrısı olduğu öğrenildi. Yapılan muayenede artrit ve eklem deformitesi yoktu. Hastadan RF, anti CCP, SS-A, SS-B, ANA, her ild el 2 yönlü grafi istendi. Gelen sonuçlarda RF: 44.3 ve anti CCP: 214.6 saptandı. Diğer otoantikorlar negatif idi. Hastanın istenen el grafisinde sağda 3. parmak PIF eklemde erozyon ve PIF eklemlerinde yaygın periartiküler osteopeni saptandı. Hastamıza akciğerdeki nodül için göğüs hastalıkları klini-ğince transbronşiyal biyopsi yapıldı. Patoloji sonucu interstisyel fibrozis ve tek tük olan histiyosit olarak geldi ve patolojik olarak alt grup ayrımına gidilemedi. Göğüs hastalıkları kliniğince yapılan solunum fonksiyon testinde FEV1/FVC: %78, DLCO: %83 olarak saptandı. Yapılan BAL sonucunda CD4/CD8 oranı: 0.3 olup tersine dönmüş olarak değerlendirildi. Yapılan sitolojik yaymalarda kronik iltihabi süreç olarak raporlandı. Sonuç: Hastamıza mevcut bulgular eşliğinde RA tanısı koyup leflunamid ve steroid tedavisi başladık. Pulmoner tutulum açısından takibe alman hastaya mevcut haliyle pulmoner tutlum açısından medikal tedavi başlanmadı. Son olarak tekrar değerlendirilen hastamızın pulmoner tutulum açısından regresyonu mevcut olup hastamızın halen tedavisine RA eklem tutulumu açısından da remisyonda olarak 2. ayda devam ediliyor. [ABSTRACT FROM AUTHOR]

Avascular necrosis, which is caused by non-traumatic factors, is not a specific disease entity but the final common result of many conditions leading to death of bone cells by the impairment of blood supply. Although associated diseases and conditions (steroid administration, alcoholism, systemic lupus erythematosus, etc.) are well known, avascular necrosis is thought to arise from a multifactorial etiology of mechanical, hormonal and hematologic factors. The goals of treatment are to maintain range of motion, to stop the progression of disease, and to reduce symptoms. If conservative treatment fails, arthroscopic debridement, core decompression, grafting, and arthroplasty are surgical alternatives according to the stage of disease. [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.)

Our aim in this study was to compare the depression and anxiety risk in patients with AS and healthy controls and also to determine the relationship between disease activity, quality of life and psychological well-being. Two hundred and forty-three patients with ankylosing spondylitis (AS) and 118 age-, sex- and education-matched healthy controls were enroled into the study. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Functional Index, and Metrology Index, Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), Hospital Anxiety and Depression Scale (HADS) including depression subscale (HADS-D) and anxiety subscale (HADS-A), Ankylosing Spondylitis Quality of Life (ASQoL) Scale, duration of morning stiffness, pain-visual analogue scale (VAS), patient and physician's global assessment of disease activity (100 mm VAS) were used to assess clinical and psychological status. Patients had similar HADS-D but higher HADS-A than healthy controls. Patients with high risk for depression and anxiety had higher scores in BASDAI, BASFI and also poorer scores in VAS pain, patient global assessment, physician global assessment, HAQ-S and ASQoL. There was a negative correlation of HADS-D and HADS-A scores with educational level of the patients. Higher scores in HADS-D and HADS-A indicated poorer functional outcome and quality of life. Multivariate logistic regression analysis revealed that the HADS-D (OR = 6.84), HAQ-S (OR = 1.76), VAS pain score (OR = 1.03) and ESR (OR = 1.02) were independent risk factors for higher anxiety scores whereas HADS-A (OR = 1.36) and ASQoL (OR = 1.24) were independent risk factors for higher depression scores. The psychological status had close interaction with disease activity and quality of life in patients with AS. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect almost any organ system. Its presentation and course are highly variable. The classic presentation of SLE in a woman of childbearing age is fever, arthritis, and malar rash triad. However, patients may present rare types of manifestations such as idiopathic thrombocytopenic purpura. [ABSTRACT FROM AUTHOR]

Amaç: Romatoid artrit (RA), en sık rastlanan sistemik, otoim-muıı, simetrik olarak eklemlerde artrite yol açan, kronik infla-matuar bir hastalıktır. Romatoid artrit genellikle diartrodial eklemlerin aıtritidir. RA'da kalça eklemi tutulumu hastaların %20'siııde görülür. Omuz eklemi gibi derinde olduğundan fizik muayenede kalça ekleminin inspeksiyonu ve palpasyonu çok zordur. Erken donemde kalça tutulumu sıklıkla asemptomatik-tir. Ancak kalça, aşağı bel bölgesi ve aynı taraftaki diz ekleminde ağrıya neden olabilir. 44 yaşında uzun yıllardır RA nedeniyle taldpli ve 6 yıldır infliximab tedavisi alan şiddetli kalça tutulumu olan cerrahiye yönlendirdiğimiz olgumuz dolayısıyla RA'nın kalça ekleminde de destrüktif gidebildiğini ve uygun hastaların TKP'ye yönlendirilmesi gerektiğini hatırlamış olduk. Olgu: 44 yaşında bayan hasta kalça hareketlerinde kısıtlılık, gluteal bölgede ve uylukta yoğunlaşan hareket ile artan ağrı şikayeti ile başvurdu. Hastanın sorgusunda Romatoid artrit nedeniyle taldpli olduğu ve 6 yıldır infliximab tedavisi aldığı öğrenildi. Hastanın muayenesinde kalça eklem hareket açıklıkları ileri derecede azalmış ve ağrılı idi. Faber testi negatif Fadır testi pozitif idi. Çekilen grafisiııde (Şekil PS-230) bilateral ileri derecede femur başında destrüksiyon eklem aralığının belirgin daraldığı görüldü. Alınan tetkiklerinde inflamatuar değerleri normaldi. Hastanın romatoid faktörü (RF) negatif anti CCP ise pozitif idi. Aktif artriti yoktu. Uzun yıllardır RA nedeniyle tedavi gören anti tnf kullanan yüksek doz nsaıd, steroid ihtiyacı ve ara sıra narkotik analjezik alımı olan hasta ortopedi bölümüyle koıı-sülte edilerek uygun egzersiz programı da önerilerek total kalça protezi amaçlı yönlendirildi. Sonuç: Hastanın aldığı inflbdmab tedavisi operasyondan 1 ay önce kesildi. Hasta rutin antibiyotik profilaksisi ve lüzum halinde steroid tedavisi ile operasyona yönlendirildi. Aldığı inflixi mab tedavisinin operasyon sonrası yara iyileşmesi tamamlanınca devam edilmesi bu sürede NSAID ve kortikosteroidler ile medikal tedavinin devamı planlandı. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Turkish Society for Rheumatology 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.)

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis of childhood, affecting the small blood vessels. The disease is a clinical syndrome characterized by multiple organ involvement including the skin, joints, gastrointestinal tract, and the kidneys. Headache and behavioral changes can be frequently seen during the course of the disease, but severe neurological signs such as seizures, focal neurologic deficits, intracerebral hematoma, mononeuropathies, and polyradiculoneuropathies are the rare complications of HSP. In this report, we described a 17-year-old girl with HSP who presented with seizures and disturbance of consciousness. The subsequent magnetic resonance imaging of the brain demonstrated findings consistent with cerebral vasculitis. The pulse steroid therapy was performed immediately after the diagnosis and clinical improvement was achieved rapidly. In conclusion, we suggest that cerebral vasculitis should be considered in all HSP patients with neurological symptoms and signs. [ABSTRACT FROM AUTHOR]

A case study of 27-year-old man presented to emergency department with complain of left hip pain is presented. It mentions that the patient had no history of tobacco use, alcohol use, intravenous drug use or any other factors for HIV infection. His physical examination revealed painful hip movement and a positive straight leg raise sign and adds that the patient was diagnosed with Brucellosis.