Turkish Journal of Rheumatology - 2005; 20(3)

COMPARISON OF EFFECTS OF BIOFEEDBACK ASSISTED ISOMETRIC EXERCISE AND ELECTRICAL STIMULATION ON QUADRICEPS STRENGTH IN KNEE OSTEOARTHRITIS

Dilek Durmu�, Ferhan Cant�rk, Gamze Alayl� — 2005-06-01

The aim of this study was to evaluate the effects of biofeedback assisted isometric exercise and electrical stimulation program on quadriceps strength and thigh circumference measurements. Fifty women aged between 42 and 74 years old with the diagnose of knee osteoarthritis (OA) according to American College of Rheumatology (ACR) criteria participated in the study. Patients were randomized into two groups. For both groups a 20 minute therapy was applied 5 days a week. Both groups were treated for 4 weeks. The patients were evaluated before and after the treatment. 1 RM (Repetition Maximum) and 10 RM were used to evaluate muscle strength. Thigh circumference was measured 15 cm above the patella. There were statistically significant improvements in both groups in 1 RM and 10 RM values showing the improvement in muscle strength (p<0.001). Although there was no significant improvement in thigh circumference measurement in the exercise group (p>0.05), there was statistically significant improvement in thigh circumference in the ES group (p<0.05). According to our findings we conclude that both treatment protocols can be used in the treatment of knee osteoarthritis to increase the muscle strength.

THE ASSESSMENT OF POSTURE IN MYOFASCIAL PAIN DISORDERS OF THE TEMPOROMANDIBULAR SYSTEM

2005-06-01

Many clinicians have speculated that poor posture may have a negative effect on temporomandibular disorders (TMD), symptoms, and treatment outcome. The aim of this study was to analyse poor posture seen in primary miyofasyal TMD as clinically and radiologically. Forty-eight patients (mean age: 39.4 �12.3, 45 female and 3 male) diagnosed with primary myofascial TMD according to the RDC/TMD described by Dworkin & LeResche were included in this study. Pain of the postural muscles in temporomandibular system, the types of poor posture, the level of depression, the results of double-aspects x-rays of cervical and thoracal spine and TMJ HRCT were recorded. Forward-drooping shoulder (85.4%) and forward-head posture (39.6%) were the most common faulty posture types in the postural analysis. Flattening of the cervical axis (58.3%) was observed most frequently . Upper trapezius has been interpreted as the most severely affected miyofasyal structure. As conclusion, poor posture is common in primary miyofasyal TMD and posture training may have critical importance.

EFFECT OF SEROPOSITIVITY ON BONE MINERAL DENSITY IN CHRONIC INFLAMMATORY DISEASES

Nurgul Ar�nc� Incel, Meryem Sara�o�lu, Aynur Karag�z, H.Rana Erdem — 2005-06-01

Localised and generalised bone loss in chronic inflammatory diseases result in an increased risk of fractures with associated morbidity and mortality. Our aim was to observe bone mineral density (BMD) changes in seropositive and seronegative chronic inflammatory diseases and to evaluate the effect of clinical characteristics on BMD. 75 seropositive, 15 seronegative RA and 27 AS patients with 25 healthy volunteers were included in the study. Seronegative RA patients and all AS patients were accepted as the seronegative group. BMD measurements were carried out at lumbar spine and femur neck by DEXA. We found significant difference between T scores of seropositive patients and control groups. The difference was not statistically significant between seronegative and seropositive groups though BMD values were lower for the seropositive group at either site. For the seronegative group, we found no statistically significant difference between spondyloarthropathy and seronegative RA patient groups in terms of spinal and femoral T scores. We suggest that the increased risk of OP in chronic inflammatory diseases is present but not dependent on the seropositive and seronegative characteristic of the disease.

THE EFFECTIVENESS OF ALENDRONATE SODIUM AND CALCITRIOL COMBINATION THERAPY IN POSTMENOPAUSAL OSTEOPOROSIS

Erhan Arif �zt�rk, Haydar G�k, Peyman Yal��n — 2005-06-01

The aim of this study was to investigate the efficacy of alendronate sodium and calcitriol combination therapy on bone density and bone turnover in the treatment of postmenopausal osteoporosis. 540 women between 45-70 years of age were enrolled for assessment. Among them, 200 patients who were suitable according to medical history, physical examination, laboratory parameters and bone mineral density (BMD) measurements were recruited and randomized into 4 seperate treatment groups. The first group was treated with 10 mg/day alendronate sodium and 0.25 mcgx2/day calcitriol, the second group with 10 mg/day alendronate sodium, the third group with calcitriol 0.25 mcgx2/day, and fourth group with 1000 mg/day calcium alone for 2 years. The first three groups were also given 1000 mg/day calcium. Patents were assessed at baseline and 6 months intervals. Markers of bone formation and resorption were measured at 6 months intervals. Measurement of BMD values were done at the onset and at the end of first and second year. We concluded that alendronate sodium and calcitriol combination therapy was more effective in increasing the BMDs of the lumbar spine and hip and decreasing the bone turnover in patients with postmenopausal osteoporosis.

EARLY RHEUMATO�D ARTHR�T�S

Ali Aydeniz, Faruk �endur, G�lcan G�rer — 2005-06-01

Rheumatoid arthritis is a disease that leads to joint damage and loss of function. Recent studies have shown that irreversible damage ocur within the first two years of the disease. For this reason there is a consensus about early diagnosis and proper treatment of the disease. In this review new improvement in diagnosis and treatment of rheumatoid arthritis is reviewed.

SACRAL INSUFFICIENCY FRACTURES: A CASE REPORT AND REVIEW OF THE LITERATURE

Birol Balaban, Evren Ya�ar, Arif Kenan Tan, Tun� Alp Kalyon, Murat Kocao�lu — 2005-06-01

Sacral insufficiency fracture, a type of stress fracture of postmenopausal older women, results from normal physiologic stress placed on abnormal bone with deficient elastic resistance. Low back, pelvic and groin pain that limit mobilization of the patients are seen in sacral insufficiency fractures. Bone scintigraphy and computerized tomography are common tools in diagnosis. Increased H-shaped uptake pattern in bone scintigraphy is a pathognomonic sign of bilateral fracture of sacral ala. In this case report, a 82 years old woman with sacral insufficiency fracture is presented. This pathology should be considered in the differential diagnosis of low back or pelvic pain in older patients with osteoporosis.

A CASE OF SYSTEMIC LUPUS ERYTHEMATOSUS PATIENT WITH JACCOUD ARTHRITIS AND ALGORITHM OF ATHROPATHY IN SYSTEMIC LUPUS ERYTHEMATOSUS

Erhan �apk�n, Murat Karakucak, Mehmet Tosun, Mustafa G�ler — 2005-06-01

Arthralgias or arthritis constitute the most common presenting manifestation of Systemic Lupus Erythematosus (SLE). The acute arthritis affect typically the small joint of the hands, wirsts and knees. The arthritis of SLE is typically non erosive. This condition has been called Jaccoud's arthritis. We have presented a SLE patient with Jaccoud's arthropathy and an arthropathy algorithm for SLE in this article.

POLYNEUROPATHY ARISING IN THE COURSE OF GOUT- A CASE REPORT

�zlem YOLER�, Berrin �NGEN, �lker �ENG�L, Ne�e �LMEZ, Asuman MEM��, Figen E�MEL� — 2005-06-01

Polyneuropathy arising in the course of gout may be due to various reasons. Colchicine intake, alcohol abuse and vitamin B12 deficiency are among these. A 65-year-old male patient has been reported to remind the physicians the reasons underlying the polyneuropathy seen in gouty arthritis and emphasize the difficulty of a differential diagnosis.