Background Rheumatoid arthritis (RA) is a chronic disease which affects the performance of the upper extremities. There is no method to evaluate the specific upper extremity endurance of individuals with this disease. The unsupported upper‐limb exercise test (UULEX) is a performance test that evaluates upper extremity performance (functionality and endurance). Aim The aim of this study was to examine the reliability and validity of UULEX and the minimal detectable change (MDC) in individuals with RA. Methods and Materials The study included 71 patients (15 male, 56 female) with a mean age of 52.15 ± 10.11 years. The intraclass correlation coefficient (ICC) was used to assess the reliability of UULEX. MDC estimates were calculated using baseline data. Correlations of UULEX with the Disability of Arm, Shoulder and Hand Questionnaire (DASH), Health Assessment Questionnaire (HAQ), 30‐second push‐up test and 6 pegboard ring test (6PBRT) were assessed for concurrent validity. Results The level, weight and duration scores of the UULEX test were found to be excellent for intra‐rater reliability (ICC = 0.922, 0.960, 0.958). Intra‐rater MDC values were determined to be 0.35, 2.04, and 0.80 seconds, respectively. Moderate‐excellent correlations were found between UULEX and DASH, HAQ, 30‐second push‐up test and 6PBRT (P < .05). Conclusion The results of this study showed that UULEX test is a valid and reliable method for the assessment of upper extremity performance in individuals with RA.

Objectives: This study aims to evaluate gray-scale histogram analysis of B-mode ultrasound (US) images and US elastographic features of the parotid glands in patients with Sjögren's syndrome (SS) and to explore relationships with the ultrasonographic and disease activity scores in the light of histopathological findings. Patients and methods: A total of 57 consecutive female patients (mean age 47.9±10.4 years; range 25 to 76 years) with a diagnosis of SS and 48 healthy female individuals (mean age 51.1±10.8 years; range 20 to 70 years) underwent parotid ultrasonography and real-time tissue elastography imaging. Quantitative measurements of gray-scale US images were performed using the histogram software of the scanner. The histogram ratios of the parotid glands from both sides were obtained (histogram ratio; mean gray-scale histogram parotid/mean gray-scale histogram fat). Strain ratio (SR; ratio of fat to gland parenchyma) was calculated from the color-coded images. Subjective B-mode US scoring of electronically recorded grayscale US images was performed by two radiologists independently for intra-and inter-observer agreement. Subjective assessments, quantitative measurements, and clinical parameters were compared. Results: The SR of the patient group (1.4±0.8 right side, 1.5±0.9 left side) was significantly higher than that of the control group (1.0±0.3 right side, 1.1±0.3 left side) (p<0.05). The gray-scale histogram ratio of the patient group (1.3±0.5 right side, 1.4±0.9 left side) was lower than that of the control group (1.8±0.7 right side, 1.9±0.7 left side) (p<0.05). Receiver-operating-characteristics curve yielded 66% sensitivity for both sides and 50% and 52% specificity for the right and left sides, respectively, for a cut-off SR of 1.02; 76% and 86% sensitivity for the right and left sides, respectively, and 63% specificity for both sides for a cut-off histogram ratio of 1.35. The quantitative histogram ratio method had a higher positivity rate for the diagnosis of abnormal parotid glands than subjective assessments of US images. Conclusion: Sonoelastography and gray-scale histogram analysis of the parotid glands may be used as auxiliary tools to detect parotid gland sonographic abnormalities in patients with SS.

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Sjögren's syndrome (SS) is a chronic, systemic, autoimmune disease characterized by lymphocytic infiltration of all exocrine glands, especially tear and salivary glands. 1 Typical symptoms of SS are dry eyes, mouth and vagina but other mucosa can also be involved, resulting in a disturbing sicca syndrome that can impair quality of life. 2 As in other autoimmune diseases, SS predominantly affects women more than men and may occur in patients of all ages but typically has onset in the 4th to 6th decades of life. 3 A good sexual life is an important factor in global health status 4 and vaginal dryness and dyspareunia experienced in SS have a negative effect on participation in sexual activity. 5 The classic triad of dry eyes, mouth and vagina is known to most gynecologists as