Turkish Journal of Rheumatology - 2003; 18(2)

THE EVALUATION AND THE REHABILITATIVE APPROACH IN ARTHROGRYPOSIS

Figen Ard��, Z. Rezan Yorganc�o�lu, Ya�ar Kahraman, G�lin F�nd�ko�lu — 2003-06-01

Amyloplasia or classic arthrogryposis is the most common form of arthrogryposis multiplex congenita (AMC). Characteristically congenital contractures are seen in upper and/or lower extremity, normal intelligence, and absence of major systemic malformation and chromosomal abnormality are the main features of classic AMC. We have reviewed diagnostic and rehabilitative approaches of AMC for a case of 8-months old baby with classic AMC.

BATH INDEXES IN THE EVALUATION OF PATIENTS WITH ANKYLOSING SPONDYLITIS

Kamil Yaz�c�o�lu, A. Salim G�ktepe, Bilge Y�lmaz, ��kr� G�nd�z — 2003-06-01

In this study, we investigated the application of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Index (BASGI) and Bath Ankylosing Spondylitis Metrology Index (BASMI) to the Turkish population and the relationship among those indexes. The study was performed in GATA PM&R Department and 128 male patients diagnosed with definite Ankylosing Spondylitis according to 1966 New York criteria. The patients are requested to fill the forms of BASDAI, BASGI and BASFI on a visual analog scale under the supervision of a physician. For metrology index, the physician made the measurements. In the end of the study, metrology index (BASMI) showed no correlation with the disease activity index (BASDAI), whereas the functional index (BASFI) showed a good correlation with both BASMI and BASDAI. In conclusion, patients with Ankylosing Spondylitis need life long follow-up and BASMI, BASDAI, BASFI, and BASGI can be helpful for patient evaluation.

THE EFFECT OF CALCITONIN IN LOMBER SPINAL STENOSIS

�zlem Levent, Burcu Yan�k, �ehim Kutlay, S�reyya Ergin — 2003-06-01

Lomber spinal stenosis is a chronic degenerative syndrome which come out from pressure on neural structures by stenotic spinal canal or intervertebral foramen and is characterized by neurogenic claudication clinically. Education of the patient is very important, treatment choices are conservative approaches such as physical therapy, epidural enjections, calcitonin therapy and surgical decompression operations. 41 patients diagnosed as lomber spinal stenosis clinically and radiologically were taken to the study. Patients were randomized into two groups. In the first group (n=20), the patients were included in a physical therapy program. The second group (n=21) took salmon calcitonin 100 IU daily for 15 days, in addition to the physical therapy. The patients were evaluated two times, initially and 2 months later. In conclusion, intensity of pain decreased and lumbar range of motion increased in both of the groups. There was improvement in paresthesia in the calcitonin group.There was no significant improvement in walking distance in both of the groups. According to these results, calcitonin therapy is found effective as and can be used safely in patients with lumbar spinal stenosis.

THE EFFECT OF ANKYLOSING SPONDYLITIS ON HEALTH-RELATED QUALITY OF LIFE AND DIFFERENT ASPECTS OF SOCIAL LIFE

2003-06-01

The aim of this study is to put forward the patients' assessment about the disease, impact of the disease on whole life fields, and to measure of quality of life in ankylosing spondylitis. 101 patients with the diagnosis of AS according to modified New York criteria were enrolled in this study. The patients' general assessment about the disease was assessed with Likert scale, and quality of life was assessed with short form (SF-36). The most affected subscales of quality of life were role limitations caused by physical health problems, general health perceptions and pain. The physical functioning and social functioning value differences between employed and unemployed patients before the disease were statistically significant (p<0.004). The physical functioning, role limitations caused by physical health and emotional problems, general health perception, vitality, social functioning and mental health value differences between the patients employed before the disease but unemployed after the disease and employed before and after the disease were statistically different (p<0,001, p<0,001, p=0,007, p=0,001, p=0,001, p<0,001 and p=0,005 respectively). The physical functioning and general health value differences between the patients unemployed and employed before but unemployed after the disease were statistically significant (p=0.002 and p=0.002 respectively). The values of subscales were lower in the patients unemployed because of the disease. General health and physical role power values of patients with an education duration below and over 8 years were significantly different (p=0.002 and p=0.013 respectively). The difference in approach to marriage between the patients according to education level was also found to be significant (p=0.024). As a result ankylosing spondylitis is such a chronic disesase in which the life fields and quality of life are affected in addition to physical harm.

METABOLIC, ENDOCRIN AND SOCIO -CULTURAL RISK FACTORS IN PATIENTS WITH PRIMARY OSTEOARTHRITIS OF THE KNEE AND RELATIONSHIP WITH RADIOLOGICAL FINDINGS

Nehir Samanc�, Cahit Ka�ar, Meltem Say�n, Tiraje Tuncer — 2003-06-01

The aim of this study was to investigate some of the risk factors associated with osteoarthritis of the knee and the relationship of these risk factors with radiographic findings. One hundred patients with no known metabolic or inflammatory articular diseases who had a clinical and radiological diagnosis of knee osteoarthritis, and eighteen sex and age matched healthy controls were included in this study. All patients and controls were questioned for accompanying systemic diseases, life style and daily life habits. All patients had undergone physical examination and anthropometric measures were (height, weight, subcutaneous fat tissue) determined. The laboratory parameters like serum glucose, uric acid, lipids, calcium, phosphorus, alkaline phosphotase levels were measured. Radiographic findings were assessed by using the method of Kellegren Lawrence. Weight, body mass index, diabetes mellitus, hypertension, serum glucose and uric acid levels and sedentary life style were significantly higher when compared with healthy controls. A positive correlation was observed between the age, pain, post menopousal duration and centrality ratio and Kellegren Lawrence radiological scores. In conclusion, weight, distrubiton of fat tissue, sedentary life style, some metabolic factors and systemic diseases were determined to be the risk factors for knee osteoarthritis. Determination of modifiable risk factors and avoidance of them may help to decrease the incidence and severity of knee osteoarthritis.

UNDIFFERENTIATED SPONDYLOARTROPATHY: A CASE REPORT

Saime Sar�o�lu Ay, Bur�in Aslan �z�akar, G�lay Din�er — 2003-06-01

Undifferentiated spondyloarthropathies (uSpA) represent a group of patients with clinical and radiographic features suggestive of a seronegative spondyloarthropathy but not fulfilling the diagnostic criteria for any of the established diseases (ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthtitis) in this group. Undifferentiated spondyloarthropathy is one of the common disease subset in the spectrum of seronegative SpA. Since uSpa may gradually develop definite SpA, systematic follow up is recommended. In this case, we present a 27-year-old man who fulfilled the European spondyloarthropathy Study Group (ESSG) criteria for seronegative spondyloarthropathies but not meet criteria for any of the disease and diagnosed as uSpA.

RIGHT HEMIPLEGIA FOLLOWING LIGHTNING STRIKE: CASE REPORT

2003-06-01

Lightning strike is important because of its high risk of mortality. Although the neurologic changes following lightning have been described frequently, permanent deficit is not frequent. In this case we present a case with right hemiplegia and left corneal perforation after lightning strike. Because of the existing permanent deficits and complications, cases with the same etiology are reviewed.

AN ADULT CASE OF HENOCH-SCH�NLEIN PURPURA WITH GASTROINTESTINAL AND RENAL INVOLVEMENT

I��lay Nadir, Saniye Top�u, Ece Kaptano�lu — 2003-06-01

Henoch-Sch�nlein purpura is a small vessel vasculitis, commonly seen in children. Severe organ involvement is reported to be less than 2 %. Here we present an adult Henoch-Sch�nlein Purpura case with gastrointestinal and renal involvement.

CHRONIC TOPHACEUS GOUTY ARTHRITIS RESEMBLING RHEUMATOID ARTHRITIS

Nurdan Kotevo�lu, Beril �zcan, Banu Kuran — 2003-06-01

Chronic gouty arhritis with polyarticular type may mimic clinical presentation of rheumatoid arthritis. The coexistence of these two diseases was reported in previous case studies. Correct diagnosis can be reached through careful and detailed history taking, assessing tophus, evaluating radiological and laboratory findings; besides identification of monosodium urate crystals in the synovial or subcutaneous tissue. We aimed to discuss fourty-eight years old male patient, who had joint complaints for years and being treated as rheumatoid arthritis and later diagnosed as polyarticular gouty arthritis under the light of these information.

SPINAL TRACTION

Saime Sar�o�lu, G�lay Din�er — 2003-06-01

Spinal traction is a technique using a force or a system of force to seperate joint face and bone fragmants, and to stretch and elongate the soft tissue. Spinal traction is most commonly used in cervical and lomber regions. Thoracic, sacral and pelvic tractions are also used but with little effect. Traction can be continuous, sustained and intermittent. Traction is obtained by using a force with an optimal position, amount and duration. The correct position of the patient and the correct angle of the pull, the traction can be localised to a certain spinal area. The purpose of traction is to decrease pain and improve function.