Effects of Hypermobility on Schober Test and Chest Expansion Scores

DergiPark: 420774tmsjAims: Hypermobility is a condition which increases the joint mobility range. Beighton method is used in diagnosisof hypermobility. Schober test and chest expansion measurement are frequently used to evaluate mobility of spineand expansion ability of chest in ankylosing spondylitis volunteers. In this study, it is aimed to investigate the impactof hypermobility on Schober test and chest expansion.Methods: The data of 300 healthy volunteers aged between 18 and 32 was collected. Beighton score, chest expansionand Schober score of all volunteers were measured and statistically analyzed using SPSS. Student’s t-test wasperformed to compare both groups. As for descriptive statistics, mean ± standard deviation and numbers were used.Results: One hundred twenty-two cases having Beighton score of 4 and above included in hypermobility groupwhile 178 cases under 4 served as control group without hypermobility. No significant relation in terms of chest expansionand Schober score was found out between groups. There was a slight positive correlation between Beightonscore and Schober score in whole group. In male population, both test scores had a correlation with Beighton scorewhile only chest expansion had correlation in female population.Conclusion: Although Beighton score seemed to have no effect on Schober or chest expansion scores in betweengroup comparisons, correlation analysis revealed that hypermobility may affect the scores, especially in males

Agreement of Turkish Physiatrists with the Assessment in Spondyloarthritis International Society and the European League Against Rheumatism Recommendations for the Management of Ankylosing Spondylitis and Rheumatoid Arthritis

Background: New developments in the field of targeted therapies or biologic agents led more effective management of ankylosing spondylitis (AS) and rheumatoid arthritis (RA). Recommendations for the management of rheumatic diseases propose to reduce inappropriate use of medications, minimize variations among countries, and enable cost-effective use of health care resources. Objective: The aim this study was to evaluate conceptual agreement of ASsessment in SpondyloArthritis International Society (ASAS) and the EUropean League Against Rheumatism (EULAR) recommendations for the management of AS and EULAR recommendations for RA and to assess the rate of application among Turkish physiatrists in daily clinical practice. Methods: An online survey link has been sent to 1756 Turkish physiatrists with e-mails asking to rate agreement on 11-item ASAS/EULAR AS recommendations and 15-item EULAR RA recommendations with synthetic and biological disease-modifying anti-rheumatic drugs. Also barriers and difficulties for using biologic agents were assessed. Results: Three hundred nine physiatrists (17.5%) completed the survey. The conceptual agreement with both recommendations was very high (Level of agreement; mean 8.35±0.82 and 8.90± 0.67 for RA and AS recommendations, respectively), and the self-declared application of overall recommendations in the clinical practice was also high for both RA and AS (72.42% and 75.71%, respectively). Conclusion: Turkish physiatrists are in good conceptual agreement with the evidence-based recommendations for the management of AS and RA. These efforts may serve to disseminate the knowledge and increase the current awareness among physicians who serve to these patients and also implementation of these recommendations is expected to increase as well.PubMedScopu

Türkiye Romatizma Araştırma ve Savaş Derneği ankilozan spondilit ulusal tedavi önerileri

Objectives: To develop Turkish League Against Rheumatism (TLAR) National Recommendations for the management of ankylosing spondylitis (AS). Materials and methods: A scientific committee of 25 experts consisting of six rheumatologists and 19 physical medicine and rehabilitation specialists was formed by TLAR. Recommendations were based on the 2006 ASsessment in Ankylosing Spondylitis International Working Group(ASAS)/European League Against Rheumatism (EULAR) recommendations and a systematic review of associated publications between January 2005 and September 2010. A Delphi process was used to develop the recommendations. Twelve major recommendations were constructed for the management of AS. Voting using a numerical rating scale assessed the strength of each recommendation. Results: The 12 recommendations include patient assessment, patient follow-up along with pharmacological and non-pharmacological methods. Some minor additions and changes have been made to the ASAS/EULAR recommendations. All of the recommendations had sufficient strength. Conclusion: National recommendations for the management of AS were developed based on scientific evidence and consensus expert opinion. These recommendations will be updated regularly in accordance with recent developments.Türkiye Romatizma Araştırma ve Savaş Derneği᾽nin (TRASD) Ankilozan Spondilit (AS) için ulusal tedavi önerilerinin oluşturulmasıdır. Gereç ve yöntemler: TRASD tarafından altı Romatoloji ve 19 Fiziksel Tıp ve Rehabilitasyon uzmanı olmak üzere toplam 25 kişiden oluşan bir bilimsel kurul oluşturuldu. Önerilerde 2006 yılında yayınlanan Ankilozan Spondilit Değerlendirme Uluslararası Çalışma Grubu (ASAS)/Romatizmaya karşı Avrupa Ligi (EULAR) önerileri ve Ocak 2005 - Eylül 2010 arasında yayınlanmış olan ilişkili yayınlar konusundaki sistematik bir inceleme temel alındı. Öneriler oluşturulurken Delphi süreci kullanıldı. Ankilozan spondilit tedavisi ile ilgili 12 ana öneri oluşturuldu. Oylama yapılarak önerilerin güçlülük düzeyi bir nümerik derecelendirme skalası ile belirlendi. Bulgular: On iki öneri hasta değerlendirilmesini, hasta takibini ve farmakolojik ve non-farmakolojik yöntemleri içermektedir. ASAS/EULAR önerilerine bazı ilaveler ve önerilerde bazı küçük değişiklikler yapılmıştır. Tüm öneriler yeterli kuvvete sahipti. Sonuç: Bilimsel kanıtlar ve uzmanların görüş birliği ile AS tedavisine yönelik ulusal öneriler oluşturulmuştur. Bu öneriler, yeni gelişmeler doğrultusunda düzenli olarak güncellenmelidi

Correlation Between Digital X-Ray Radiogrammetry Findings and Bone Mineral Density in Postmenopausal Women

The relation between bone mineral density (BMD) determined by dual energy X ray absorptiometry (DEXA) and radiogrammetric measurements on digital radiographies was investigated in this study. Fifty-seven postmenopausal women who had applied for DEXA measurement were included in the study. External diameter (ED) and internal diameter (ID) measurements were performed on the mid-points of the longitudinal axis of the non-dominant second metacarpal bone on digital radiographic images. By using these two measurement values, the combined cortical thickness (CCT), cortical area (CA), medullary area (MA), metacarpal index (MI) and cortical ratio (CR) values were determined by simple geometrical calculations. The osteoporosis group had 28 women and the control group 29 women after DEXA evaluations. ID and MA were found to be significantly higher (p<0.001); and CCT, CR and MI significantly lower (p<0.001) in women with osteoporosis. BMD of lumbar spine (vertebrae L2-L4) positively correlated with CCT (p<0.05). Positive correlations were found between BMD of femur neck and CCT (p<0.001), MI, CR (p<0.05). BMD of femur Ward’s triangle correlated with CCT, MI and CR positively while it correlated negatively with ID and MA (p<0.001). Similarly BMD of femur trochanter showed positive correlations with CCR, CA, MI, CR (p<0.001), and negative correlations with ID and MA (p<0.05). No significant threshold value could be provided in the ROC curves in order to discriminate patients with osteoporosis from normal. The concordant relations found between bone geometry measurements and DEXA seemed to be encouraging to prove probably the value of digital radiogrammetry for the discrimination of osteoporotic patients from normal, in studies with larger patient population

Does a correlation exist between radiological findings and pain or function in knee osteoarthritis? A cross-sectional analysis of the radiological findings obtained from two various conventional radiological techniques Di̇z osteoartri̇ti̇nde radyoloji̇k bulgularla aǧri veya fonksi̇yon arasinda i̇li̇şki̇ var midir? İki ayri konvansiyonel radyografik yöntem ile elde edilen radyolojik bulgulari deǧerlendiren kesitsel bir analiz

There have been concerns about the relation between radiological and clinical symptoms in knee osteoarthritis (OA). The aim of this study was to compare the Kellgren-Lawrence (K/L) grading, semiquantitave osteophyte score (SOS), the medial joint space score in supine anteroposterior (AP) film of the extended knees (SupMJS), the medial joint space score in AP film of standing knees in semiflexion (StMJS), with pain, range of motion (ROM) and function in patients with knee OA. In 37 patients with knee OA, pain was evaluated with visual analog scale, ROM with goniometry and the function with Lequesne functional index (LFI). Pain with motion was higher, but the active and passive flexion ranges were less in grade 4 K/L patients when compared with earlier grades. All radiological criterias except SupMJS were in significant positive correlation with only motion pain while all radiological parameters correlated negatively with active flexion ranges. No significant correlation was found for other pain types and LFI. In lineer regression analysis only SOS was observed to have relation with motion pain (Motion pain score=3.757+1.064x SOS). It seemed to be wise to obtain AP films of standing knees in semiflexed position and take care of StMJS together with K/L classification and SOS in order to predict the motion pain in patients with knee OA