A rare cause of chronic hip pain: Intraarticular synovial chondromatosis

A 23-year-old male patient presented to our clinic with pain and limited motion in the right hip. The pain started about 3 years previously and increased over time, spreading to the trochanteric region of the right hip and the right groin. The characteristic of the pain was mechanical. He did not feel pain while sleeping. Prolonged sitting or standing caused the hip to lock. Previously, he had received physical therapy and analgesic medications but there had been no significant improvement. There was no pain in any other joint, and there was no history of disease or trauma associated with the hip. Physical examination revealed an antalgic gait. Palpation of the iliopsoas muscle caused pain. The motion of the right hip joint was limited and painful in all directions, whereas lumbar and left hip joint motions were unrestricted and painless

An unusual site for renal metastasis: A pictorial presentation

WOS: 000346402700015PubMed ID: 24982001The differential diagnosis of shoulder pain and restricted motion includes primary or metastatic cancer. Common cancers, such as breast, prostate, thyroid, lung, and renal, frequently metastasize to bone [1]. Bone metastasis is rarely asymptomatic, rather triggering refractory and persistent bone pain. Osteolysis is accompanied by increased bone fragility and pathologic fractures. These typically occur in weight-bearing bones such as the femur or pelvis. Breast, lung, and renal metastases cause extensive bone destruction and pain [2]

Comparison of the efficacy of different concentrations of diclofenac sodium phonophoresis (1.16% vs 2.32%) in patients with knee osteoarthritis: A randomized double -blind controlled trial

PURPOSE OF THE STUDY The objective of the present study is to compare the efficacy of two different concentrations of diclofenac sodium phonophoresis (DSPH) (1.16% vs 2.32%) in patients with knee osteoarthritis (OA). MATERIAL AND METHODS A randomized, double-blind, controlled design was applied. Ninety patients (mean age SD, 59.98 8.89 years) who had Kellgren-Lawrence (K-L) grades II to III knee OA were randomly allocated into three groups; 1.16% DSPH, 2.32% DSPH, TUS (30 in each group). Each patient was treated five sessions per week for two weeks. A 100-mm visual analogue scale (VAS) for usual pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were evaluated before and after treatment in all groups. RESULTS The VAS pain and WOMAC scores were significantly improved after treatment in all groups (p < 0.05). The 2.32% DSPH showed more significant effects than the 1.16% DSPH, both in improving WOMAC- pain and physical function scores (p = 0.020, p = 0.008) and reducing the VAS pain measure, although it did not reach the level of significance (p = 0.077). The 2.32% DSPH was superior to the TUS, both in reducing the VAS pain measure (p < 0.001) and in improving WOMAC-pain, stiffness, physical function and total scores (p = 0.022, p = 0.016, p < 0.001, p < 0.001 respectively). 1.16% DSPH significantly reduced stiffness and physical function scores compared with TUS (p = 0.042, p = 0.047). CONCLUSIONS DSPH and TUS are effective treatments for knee OA. Our results indicated that 2.32% DSPH produces additional benefits to functional improvement and pain reduction compared with 1.16% DSPH in K-L grades II to III knee OA

Mittleres thrombozytenvolumen und neutrophilen-lymphozyten-ratio in bezug zu entzündungsmarkern und anti-ccp bei rheumatoider arthritis

Background: Various thrombocyte markers and white blood cell levels and their subtypes have recently been investigated in association with infl ammation. The purpose of this study was to determine the correlation of mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) with disease activation and clinical parameters in rheumatoid arthritis (RA) patients. Methods: 84 RA patients and 60 healthy controls were included. Platelet, MPV, white cell, neutrophil and lymphocyte levels in full blood counts were investigated, and NLR was calculated. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), disease activation score (DAS 28) and a health assessment questionnaire (HAQ) were used in the evaluation of RA. Results: In the present study a total of 144 patients was enrolled, 84 with RA and 60 healthy individuals. 75.2 % (n = 108) were women and 24.8 % (n = 36) were men. The patients with RA had lower MPV than control individuals (MPV; 8.52 ± 1.15 fL and 8.92 ± 0.87 fL, respectively) and CRP (r: − 0.234, p = 0.005). RA patients’ mean NLR was signifi cantly higher than that of the control group (2.74 ± 1.74 and 1.80 ± 0.78, respectively; p < 0.001). Furthermore, anti-CCP positive patients had higher NLR than anti-CCP negative patients (NLR; 2.51 ± 1.92 and 1.95 ± 1.22, p = 0.019 respectively). NLR was positively correlated with ESR (r = 0.190, p = 0.023), CRP (r = 0.230, p = 0.035) and anti-CCP (r = 0.300, p = 0.005). Conclusion: In conclusion, MPV and NLR together with acute phase reactants can be a useful index for showing infl ammation in RA patients.Einleitung: Verschiedene thrombozytäre Marker und Grenzwerte von Leukozyten und ihren Subtypen sind in der jüngeren Vergangenheit bezüglich ihres Zusammenhangs mit Entzündung untersucht worden. Ziel dieser Untersuchung war die Korrelation des mittleren Thrombozytenvolumens (MPV) und der Neutrophilen/Lymphozyten Ratio (NLR) mit der Krankheitsaktivität und klinischen Parametern bei Patienten mit rheumatoider Arthritis (RA). Methoden: 84 RA Patienten und 60 gesunde Kontrollen wurden eingeschlossen. Aus dem Blutbild wurden Thrombozyten, MPV, Leukozyten-, Neutrophilen- und Lymphozytenwerte untersucht und die NLR errechnet. Die Erythrozytensedimentationsrate (ESR), C-reaktives Protein, Rheumafaktor (RF), anti-zyklisches citrullinieres Peptid (anti-CCP), der Krankheitsaktivität-Score DAS 28 und ein Gesundheitsbewertungsbogen (HAQ) wurden für die Bewertung der RA herangezogen. Ergebnis: In die vorliegende Studie wurden 144 Patienten eingeschlossen, 84 mit RA und 60 gesunde Kontrollen. 75,2 % (n = 108) waren Frauen und 24,8 % (n = 36) waren Männer. Patienten mit RA hatten ein niedrigeres MPV als die Kontrollen (MPV; 8,52 ± 1,15 fL bzw. 8,92 ± 0,87 fL) und CRP (r: − 0,234, p = 0,005). Die mittlere NLR von RA Patienten war signifi kant höher als die der Kontrollgruppe (2,74 ± 1,74 bzw. 1,80 ± 0,78; p < 0,001). Außerdem hatten anti-CCP positive Patienten höhere NLRs als antiCCP negative Patienten (NLR; 2,51 ± 1,92 bzw. 1,95 ± 1,22 p = 0,019). Die NLR korrelierte positiv mit der ESR (r = 0,190, p = 0,023), dem CRP (r = 0,230, p = 0,035) und dem anti-CCP (r = 0,300, p = 0,005). Schlussfolgerung: MPV und NLR können gemeinsam mit Akutphase-Proteinen ein hilfreicher Index für die Entzündungsaktivität bei RA Patienten sein