Pragmatic Management of Hand Involvement in Extended Oligoarticular Juvenile Idiopathic Arthritis: Ultrasound-guided Serial Interphalangeal Joint Injections

Small-joint involvement, including the interphalangeal joints of the hand, is less common in oligoarticular juvenile idiopathic arthritis (JIA). Ultrasound (US)-guided joint injections are also plausible for children. However, US-guided injections into pediatric small joints make the tips and tricks special because of the more difficult injection technique and greater risk of potential complications than with large joints. Here, we report the tips and tricks of serial US-guided interphalangeal joint injections in a male child with oligoarticular JIA who progressed to extended polyarthritis after an initial 6-month follow-up

Unusual findings in ultrasound screening for carpal tunnel syndrome in a patient with acromegaly: Bifid median nerve and persistent median artery

Carpal tunnel syndrome (CTS) is a common complication in acromegaly and is often associated with enlargement of the median nerve. Morphological changes in the median nerve and surrounding tissues can be visualized easily by ultrasound (US) scanning in suspected patients. Ultrasonography also offers priceless contributions to visualization of anatomical variations and pathological conditions that may potentially be associated with CTS. We present the presence of bifid median nerve and persistent median artery, which are both unusual findings, during the US screening for CTS in a 36-year-old male patient with acromegaly

The relationship between muscle size, obesity, body fat ratio, pain and disability in individuals with and without nonspecific low back pain.

AbstractPatients with nonspecific low back pain (NSLBP) may face motor control problemsand health disability barriers during various tasks. However, studies investigating theextent of these disadvantages, and possible associated factors are quite limited inpatients with NSLBP. To compare motor control performances and physical assessment domains between patients with NSLBP and asymptomatic controls. Twentyseven patients with NSBLP and 27 age- and sex-matched asymptomatic controls participated in this cross-sectional study. Ultrasonographic imaging was used to determine abdominal and multifidus muscles thicknesses and adipose tissue rate. Visualanalog scale was used to assess LBP severity. Body mass index (BMI) and OswestryDisability Index (ODI) scores of the participants were physical assessment domains ofLBP. BMI values were greater in the NSLBP group compared to the asymptomaticparticipants. ANCOVA revealed a significant interaction effect regarding externalabdominal oblique and multifidus lumborum muscles thickness, and abdominal adipose tissue (p = 0.015; p = 0.001; p = 0.006), respectively in terms of two groups.The thicknesses of these muscles were lesser in the NSLBP group compared with thecontrol group. Similarly, abdominal adipose tissue was higher in the NSLBP group.The stepwise multiple regression analysis demonstrated that the Oswestry Disability Index and abdominal adipose tissue rate were significant and independent factors of the low back pain severity with 73.5% of the variance. The study resultsindicate that increased disability and fat infiltration are possible determinantsinfluencing pain severity, although further research is required. Examining musculoskeletal properties of lumbar region could provide information about the limitationin patients with NSBLP.KEYWORDSabdominal muscles, adipose tissue, back pain, diagnostic imaging, paraspinal muscles</p

Skeletal Muscle Mass, Muscle Strength, and Quality of Life in Adult Patients with Familial Mediterranean Fever: A Comparative Study with Healthy Controls

Aim: This study (1) compared skeletal muscle mass (SMM) and muscle strength in familial Mediterranean fever (FMF) patients with those of healthy controls (HCs) and (2) investigated the association of SMM and muscle strength with disease severity and quality of life (QOL). Materials and Methods: This study included 31 FMF patients and 30 matched HCs. Disease severity was evaluated using the International Severity Scoring System for FMF (ISSF). Body composition parameters were measured using a bioelectrical impedance analysis. Grip and pinch strengths were calculated for muscle strength. Health status was assessed with Short Form 36 (SF-36). Results: The all-body composition parameters of the FMF patients, including SMM, were similar to those of the HCs, with significantly lower grip and pinch strengths. All SF-36 scores of the FMF patients were significantly lower than those of the HCs. Positive correlations were observed between muscle-related indices and pinch strength for some SF-36 domains. Conclusion: Muscle- or fat-related indices were similar among adult patients with FMF and the HCs. In contrast, patients with FMF had a poorer health-related QOL and lower grip and pinch strengths than the HCs. Further studies are needed to determine the clinical significance of these correlations in patients with FMF