Early passive mobilization in patients with zone V injuries resulted in higher percentage of good to excellent results when compared with zone II injuries. However, this does not translate into recovery in grip strength and disability. This study suggests that although the level of the injury is an important factor for the anatomic improvement, it may not be the predictor of functional improvement.

This study aimed to analyze the agreement between FRAX scores calculated with and without femoral neck (FN) bone mineral density (BMD) and to investigate the resultant treatment recommendations in women with osteopenia. A cross-sectional review of postmenopausal women who were referred for DXA evaluation was conducted. One hundred twenty-nine postmenopausal women aged 40 years and older with osteopenia [FN T-score between -1 and (-2.5)] were recruited for the study. Absolute agreement between FRAX scores calculated with and without BMD was analyzed by intraclass correlation analysis (ICC). Thresholds recommended by National Osteoporosis Foundation were used for treatment recommendations. Correlation between demographic factors and the difference in BMD+ and BMD- FRAX scores was analyzed by Spearman correlation test. Agreement levels and treatment recommendations were also analyzed in 112/129 patients without previous fracture. Agreement between BMD+ and BMD- MO and hip FRAX scores was good (ICC 0.867) and fair to good (ICC 0.641), respectively. In patients without previous fracture, agreement between MO and hip fracture probabilities was good (ICC = 0.838 and ICC = 0.778, respectively). Treatment recommendations with respect to treatment threshold of ≥3 for hip fracture probabilities were identical in 120/129 (93 %) cases. Difference between BMD+ and BMD- fracture probabilities was correlated with age and FN BMD. In most cases, FRAX without BMD provided the same treatment recommendations as FRAX with BMD in postmenopausal women with osteopenia. Exclusion of patients with previous fracture yielded better agreement levels.

No abstract

The aim of this cross-sectional study was to evaluate the frequency of intestinal inflammation and its association with disease activity, functional status and quality of life in patients with ankylosing spondylitis (AS). A total of 25 patients with AS had undergone ileocolonoscopy and concomitant histological study. Clinical and demographical parameters, BASDAI, BASFI, and SF-36 scores were compared between patients with and without macroscopic gut inflammation (MGI). Colonoscopic study revealed MGI in 9 patients and macroscopically normal gut mucosa in 16 patients. On histological examination, of 25 patients 20 had gut inflammation, mostly in ileum. BASDAI score was higher (P < 0.05), SF-36 pain and physical scores, and chest expansion measurement were lower (P = 0.00, P = 0.01, P = 0.01), duration of morning stiffness was longer (P = 0.01) in patients with MGI. Serum C-reactive protein, erytrocyte sedimentation rate levels were similar between groups (P > 0.05). There is high prevalence of histological gut inflammation in AS patients. More active disease should suggest gut inflammation in AS patients.

In a 51-year-old woman with a history of fractures and dislocations after low intensity trauma in childhood, intensive blue sclera, short stature, and hearing loss, the diagnosis of osteogenesis imperfecta (OI) was suspected. She was referred to our clinic with hand deformities and left knee pain and stiffness. She had difficulty in walking and reported a history of immobilization for 6 months because of knee pain. She had bilateral flexion contracture of the elbows which occurred following dislocations of the elbows in childhood. She had Z deformity of the first phalanges, reducible swan-neck deformity of the third finger of the left and the second finger of the right hand, flexion contracture of the proximal interphalangeal joint of the fifth finger of the left hand, and syndactyly of the third and fourth fingers of the right hand. Flexion contractures of both knees were observed. Pes planus and short toes were the deformities of the feet. Acute phase reactants of the patient were normal. She had no history of arthritis or morning stiffness. Bone mineral density evaluated by dual-energy X-ray absorptiometry (DEXA) showed severe osteoporosis of the femur and lumbar vertebrae. She had radiographic evidence of healed fractures of the left fibula, the third metacarpal, and the fourth and fifth middle phalanges of the right hand. OI, affecting the type I collagen tissue of the sclera, skin, ligaments, and skeleton, presenting with ligament laxity resulting in subluxations and hand deformities may be misdiagnosed as hand deformities of rheumatoid arthritis.

No abstract

ÖzetAmaç: Karpal tünel sendromlu (KTS) hastalarda uygulanan kortikosteroid enjeksiyonu ile kortikosteroid fonoforez tedavilerinin klinik sonuçlarının karşılaştırılması amaçlandı. Gereç ve Yöntem: Ellerinde parestezi ve ağrı şikayetleri olan, fizik muayene ve elektromyografi ile KTS tanısı doğrulanan 32 hastanın 40 eli çalışmaya alındı. Hastalar iki gruba ayrıldı. Birinci gruba (20 el) betametazon enjeksiyonu, el-bilek ateli, egzersiz, ikinci gruba (20 el) betametazon fonoforezi, el-bilek ateli, egzersiz uygulandı. Tedavi öncesi ve tedavi sonrası 3. ayda; vizüel analog skala (VAS) ile ağrı şiddeti, Liken skalası ile uyuşma şiddeti, Boston Semptom Şiddet Skalası ve Fonksiyonel Kapasite Skalası ile semptom şiddeti ve fonksiyonel kapasite, Jamar el dinamometresi ile el kavrama gücü, pinçmetre ile lateral ve parmak ucu kavrama gücü, Grooved Pegboard el beceri testi ile parmak ince becerisi değerlendirildi. Bulgular: Ağrı, uyuşma şiddeti, el kavrama ve parmak gücü, semptom şid-deti ve fonksiyonel kapasite ve parmak beceri testlerinde her iki tedavi grubunda anlamlı düzelme tespit edildi (p<0,05). Gruplar tüm parametrelerdeki iyileşme açısından karşılaştırıldığında gruplar arasında anlamlı fark saptanmadı (p>0,05). Sonuç: Üç aylık izlem sonunda KTS'li hastaların tedavisinde, istirahat splinti ve egzersizleri ile birlikte uygulanan betametazon enjeksiyonu ile betametazon fonoforezinin eşit düzeyde KTS tedavisinde etkili olduğu bulunmuştur. Betametazon fonoforezi non-invaziv bir yöntem olması nedeniyle enjeksiyona tercih edilebilecek bir yöntemdir. Türk Fiz T›p Re hab Derg 2011;57:119-23. Anah tar Ke li me ler: Karpal tünel sendromu, steroid enjeksiyonu, fonoforez Sum maryObjective: We aimed to compare the clinical outcomes of corticosteroid injection and phonophoresis in patients with carpal tunnel syndrome (CTS). Materials and Method: In this study, we included forty hands of 32 patients who were diagnosed with CTS on the basis of electromyography and physical evaluation and who had complaints of paresthesia and pain in the hands were included to the study. The patients were separated into two groups. Betamethasone injection, splint and exercise were applied to the first group (20 hands) and betamethasone phonophoresis, splint and exercise were applied to the second (20 hands) group. Pain was evaluated by the visual analog scale (VAS), severity of paresthesia by the Liken scale, symptom severity and functional capacity by the Boston Questionnaire: Symptom Severity Scale and Functional Capacity Scale, grip strength by Jamar hand dynamometer, lateral and pulp finger strength by pinchmeter, and finger dexterity by the Grooved Pegboard test. Results: Both groups had statistically significant improvement in pain, severity of paresthesia, hand grip and finger strength, symptom severity, functional capacity and finger dexterity at the end of the 3rd month (p<0.05). However, no statistically significant difference was found between the groups for any of the parameters (p>0.05). Conclusion: At the end of the 3rd month, betameth...

We report the case of a 35-yr-old tetraplegic man who experienced increased water intake, constant thirst, and a copious amount of urine excretion after his spinal cord injury and in whom an intermittent catheterization program was unmanageable. Laboratory evaluation revealed low serum and urine osmolality, which were suggestive of psychogenic polydipsia, and hypokalemia, which might lead to polyuria with a compensatory polydipsia. His water intake was reduced with antidepressant therapy and potassium supplementation and normalized on the third month of the treatment. Physicians should be aware of the differential diagnosis of polyuria and polydipsia, which interfere with neurogenic bladder management in patients with spinal cord injury.