Gebe olmayan bir kadında kalçanın idiopatik geçici osteoporozu: vaka çalışması

Kalçanın geçici osteoporozu (KGO) öncelikle orta yaşlı erkekleri ve ge- beliğin üçüncü trimestrindeki dönemindeki kadınları etkileyen nadir bir hastalıktır. KGO kalça ağrısı ve radyolojik olarak eklem aralığında daralma veya destrüksiyon olmaksızın ortaya çıkan geçici osteopeni ile ilişkilidir. Kadınlar için tanımlanmış tek risk faktörü gebeliktir. Tipik olarak semp- tomların kendiliğinden rezolüsyonu ile benign bir seyir gösterir. Radyog- rafiler erken dönemde belirti vermeyebilir. Bu nedenle, geçici osteoporoz avasküler nekroz gibi çok sayıda diğer hastalıklarla karışabilir. Erken dö- nemlerde bu iki hastalığın birbirinden ayırt edilmesi uygun tedavi planı- nın seçilebilmesi için önemlidir. Bu yazıda, gebelik de dahil olmak üzere herhangi bir risk faktörü olmayan ve konserevatif tedavi ile yeterli iyileşme gösteren KGO’lu 35 yaşındaki kadın hasta sunulmuştur.Türk Fiz T›p Re­hab Derg 2013;59:157-60.Transient osteoporosis of the hip (TOH) is a rare disease affecting women in the third trimester of pregnancy as well as middle-aged men. TOH is associated with hip pain and temporary osteopenia apparent on radiology without joint space narrowing or destruction of the hip. Pregnancy is the only recognized risk factor for women. It typically runs a benign course with eventual resolution of symptoms. Radiographs may be unrevealing early in its course. Therefore, transient osteoporosis may be confused with many other conditions such as avascular necrosis. In early stages, it is important to distinguish between these two conditions to order to decide on an appropriate treatment plan. In this report, we present a 35-year-old woman who had TOH, without any risk factor including pregnancy, and showed sufficient improvement with conservative treatment. Turk J Phys Med Rehab 2013;59:157-60

Comparison of Radial Extracorporeal Shock Wave Therapy and Local Corticosteroid Injection Effectiveness in Patients with Carpal Tunnel Syndrome: A Randomized Controlled Study

Objective The aim of the study was to compare the effectiveness of radial extracorporeal shock wave therapy and local corticosteroid injection on pain, function, and nerve conduction studies in the treatment of idiopathic carpal tunnel syndrome. Design A total of 72 patients who were diagnosed as having carpal tunnel syndrome were included in the study. The radial extracorporeal shock wave therapy group received radial extracorporeal shock wave therapy, the local corticosteroid injection group received local corticosteroid injection, and the control group only used a resting hand splint. The patients were evaluated using a Visual Analog Scale-pain, a Visual Analog Scale-numbness, the Boston Symptom Severity Scale, the Boston Functional Status Scale, and handgrip strength tests before treatment 1 and 12 wks after the treatment. Results Both clinical and nerve conduction study parameters improved with all three groups, and this effect continued at the 12th-week follow-up of the patients. The Visual Analog Scale-pain, Visual Analog Scale-numbness, Boston Symptom Severity Scale, and Boston Functional Status Scale scores in the first week after the treatment, as well as Visual Analog Scale-pain and Boston Functional Status Scale scores in the 12th week after the treatment, were significantly lower in the local corticosteroid injection group compared with the other two groups. Conclusions Our study revealed the success of radial extracorporeal shock wave therapy, splint, and local corticosteroid injection, but symptom relief was greater in the first week and 12th week with local corticosteroid injection. © Wolters Kluwer Health, Inc. All rights reserved

Superior cluneal nerve entrapment neuropathy due to lower crossed syndrome: A case with low back pain [Alt çapraz sendroma bağlı superior kluneal sinir tuzaklanma nöropatisi: Bel ağrılı bir olgu sunumu]

The superior cluneal nerve (SCN) is a sensory nerve known to be originated from the dorsal rami of the lower thoracic and lumbar nerve roots. One of the overlooked causes of low back pain (LBP) is the SCN Entrapment Neuropathy (SCNEN). SCNEN may also be associated with SCN stretching due to lumbar movement and the poor body posture through an increase in the paravertebral muscle tonus. A 59-year-old female patient presented with chronic LBP localized on the right iliac crest and radiating to the right buttock, groin, and leg. She had increased lumbar lordosis and anterior pelvic tilt. She had a tender point over the right iliac crest, and the pain was radiating to the buttock and posterolateral thigh (Tinel sign +). She was diagnosed with lower crossed syndrome and SCNEN, and a therapeutic nerve block was performed. Clinicians should consider SCNEN as a possible diagnosis of LBP

Resorption mechanisms related with neo- vascularization for the lomber disc herniation

Lomber disk herniasyonu (LDH) bel ağrısı ve siyatiğin önemli bir nedenidir. LDH’nın magnetik rezonans görüntüleme (MRG) ile incelenmesi neo-vaskülarizasyonla ilişkili rezorbsiyon mekanizmasını ortaya çıkarmıştır. Aktive makrofajların disk dokusuyla etkileşimlerinin infamatuvar sitokinlerin üretimine yol açtığı gösterilmiştir. Buna ek olarak tümör nekrozis faktör-? (TNF -?) gibi infamatuvar sitokinler, vasküler endotelyal growt faktör (VEGF) gibi anjiogenezi uyaran faktörlerin indüksiyonu için gereklidir. VEGF endotel hücresine özgü bir mitojendir ve yeni kan damarlarının oluşumunda esaslı bir rolü vardır. Yeni oluşmuş kan damarları ve makrofaj infiltrasyonu LDH rezorbsiyonu sırasında önemli bir rol oynarlar. Bu derlemede LDH’da rezorbsiyon mekanizmaları hakkındaki güncel bilgiler özetlendi.Lomber disc herniation (LDH) is a major cause of low back pain and sciatica. MRI investigation of LDH has revealed a resorption mechanism related with neo -vascularization. It has shown that the interaction of activated macrophages with disc tissues leads to the generation of inflammatory cytokines. In addition, inflammatory cytokines such as tumor necrosi s factor-α (TNF -α) is required for the induction of angiogenesis stimulating factors such as vascular endothelial growth factor (VEGF). VEGF is an endothelial cell -specific mitogen, and it has an essential role in the formation of new blood vessels. The ne wly formed vessels and infiltrating macrophages play an important role during LDH resorption. In this review, recent knowledge on the resorbtion mechanisms of LDH is summerized

Does One Trigger The Other? Coexistence of Gout and Haglund: A Case Report

Heel pain is one of the common clinical conditions of musculoskeletal diseases. Heel pain can occur with infectious, inflammatory, mechanical and vascular causes. Haglund's deformity, one of the causes of heel pain, is an abnormal bone formation located in the posterosuperior part of the calcaneus. Achilles enthesopathy, Haglund deformity and lesions in the posterior heel are considered Haglund Syndrome. The diagnosis of Haglund Syndrome is made clinically and radiologically. In the diagnosis of Haglund syndrome, direct radiography and magnetic resonance imaging are used in radiological examination. The bony prominence on the lateral radiograph of the foot supports the diagnosis. The differential diagnosis of Haglund Syndrome with rheumatic diseases such as gout and seronegative spondyloarthritis should be made. Gout is an inflammatory rheumatic disease characterized by the accumulation of monosodium urate crystals in tissues caused by hyperuricemia. In this article, a case diagnosed with gout accompanying bilateral Haglund Syndrome is presented in the light of current literature

Can mean platelet volume be used as a biomarker for asthma?

Introduction : Platelets play important roles in airway inflammation and are activated in inflammatory lung diseases, including asthma. Aim :We evaluated the mean platelet volume (MPV), used as a marker of platelet activation, in asthmatic patients during asymptomatic periods and exacerbations compared to healthy controls to determine whether MPV can be used as an indicator of inflammation. Material and methods :Our patient group consisted of95 children with exacerbation of asthma who were admitted to our allergy clinic. The control group consisted of 100 healthy children matched for age, gender, and ethnicity. Mean platelet volume values of the patient group obtained during exacerbation of asthma were compared to those of the same group during the asymptomatic period and with the control group. We investigated factors that can affect the MPV values of asthma patients, including infection, atopy, immunotherapy treatment, and severity of asthma exacerbation. Results :The patient group consisted of 50 (52.6%) boys and 45 (47.4%) girls with a mean age of 125 ±38 months old. Mean MPV values in the exacerbation period, the healthy period, and in the control group were 8.1 ±0.8 fl, 8.1 ±1.06 fl, and 8.2 ±0.9 fl, respectively; there were no significant differences between groups (p > 0.05). The severity of asthma, severity of asthma exacerbation, immunotherapy, coinfection, eosinophil count, and IgE level also had no effect on MPV (p > 0.05). Conclusions : Although platelets play a rolein the pathophysiology of asthma, MPV measurement is insufficient to detect inflammation through platelet

Complex Regional Pain Syndrome in a Child: A Case Report

Complex regional pain syndrome (CRPS) is a painful clinical condition that usually seen on the distal extremity, affects children and adults. It is more common in adults. CRPS is usually characterized by severe pain, swelling, limitation of movement, trophic disorders, and spotted osteoporosis following triggering stimulus. CRPS-1 is not a peripheral nerve lesion, it develops following trauma, surgical applications and central nervous system lesion. On the other hand CRPS-2 occurs after peripheral nerve lesion. In CRPS-1, a more severe effect is seen than the initiating factor. CRPS-1 is a rare clinical condition in children. In this article, a 9-year-old male patient which developed CRPS-1 following lower extremity fracture is presented in company with current literature

Femoral Neuropathy in a Patient with Rheumatoid Arthritis

Femoral mononeuropathy (FMN) as an extraarticular finding of rheumatoid arthritis (RA) is a phenomenon which has not been reported previously. We report a 53-year-old female patient with RA, presenting FMN findings during the course of the disease. On examination, right quadriceps and iliopsoas muscles showed grade 3 weakness on the Medical Research Council (MRC) scale. Sensory examination revealed sensory loss in the right medial leg and thigh. Patellar tendon reflex was absent in the right side. A diagnosis of a partial right femoral neuropathy was confirmed using nerve conduction study and electromyography. The probable mechanism of FMN was thought to be vasculitis

A rare benign disorder mimicking metastasis on radiographic examination: a case report of osteopoikilosis

Osteopoikilosis (OPK) is a rare, autosomal dominant bone disorder, characterized by multiple, discrete round or ovoid radio densities scattered throughout the axial and appendicular skeleton. OPK is usually asymptomatic but rarely there may be slight articular pain and joint effusions. OPK is generally diagnosed incidentally on radiographic examinations and may mimic different bone pathologies, including bone metastases. Radionuclide bone scan has a critical role in distinguishing OPK from osteoblastic bone metastases. In this case report, we present a young man with right hip pain due to OPK, whose plain radiogram and computerized tomography findings thought cancer metastasis

Disability Distribution of Geriatric Patients Applying to the Board of Health for Disabled in a Rural Region

Objective:To determine the demographic characteristics, disability ratios, and disability distribution of geriatric patients who applied to an educational research hospital in the rural region to receive a health board report in order to benefit from the disability rights.Materials and Methods:The hospital archive was searched and the records between 01/01/2016 and 31/12/2016 were examined. The demographic characteristics of the patients, whether they were “severely disabled” or not, the number of patients with disabilities according to organ systems were determined and the disability ratios were calculated based on the “Regulation on Disability Criterion, Classification and Health Board Reports for Disability”. A list of diseases constituting the rate of disability was established and its numbers were determined.Results:Among the 699 geriatric patients who referred to the health board, 426 (60.9%) were female and 273 (39.1%) were male. The mean age of the patients was 77.62±7.74 years (minimum: 65, maximum: 104) (female: 78.07±7.54, male: 76.93±8.02), the mean disability ratio was 79.96±17.79% (10-100). The average disability ratio of females was 79.66±17.61% and the average disability ratio of males were 80.41±18.24%. There was no statistically significant difference between the male and female groups in terms of the mean disability ratio (p=0.239). Of the 202 (28.9%) patients who were considered to be severely disabled, 123 were female (60.9%) and 79 were male (39.1%). There was no statistically significant difference between male and female groups in severely disabled ratios (p=0.457). The first three organ systems constituting disability ratio in patients were the cardiovascular system, the musculoskeletal system, and the visual system. The number of patients with disabilities in the cardiovascular and musculoskeletal system was higher in women, but there was no statistically significant difference between the disability percentages of these systems.Conclusion:The highest rate of disability has been seen in the cardiovascular, musculoskeletal, and visual system in geriatric patients. In the practice of routine geriatric outpatient clinics, the pathologies of these organ systems should be evaluated in more detail and managed before creating disability