A 28-year-old female patient presented with back pain, dyspnea and coughing. Chest radiograph showed a mass in the middle zone of the right hemithorax. CT confirmed the mass was confined to the 5th rib. During the exploratory thoracotomy, a smooth, firm mass measuring 7 x 9 x 5 cm was found to have destroyed the middle and posterior parts of the 5th rib. Together with the adjacent intercostal muscles, the 5th rib was excised en-block. Postoperative pathology was cavernous haemangioma. Cavernous haemangioma of the rib is very rare, and very few cases have been reported in the literature.
Bisphosphonates are commonly used in the treatment of osteoporosis. Atypical femoral fracture (AFF) is a well-known adverse effect of bisphosphonate use. The importance of genetic factors has been demonstrated in bone quality, bone turnover, and in the response to osteoporosis treatment. Herein, we present two cases of bilateral AFFs after bisphosphonate use for a short period of time in members of the same family (mother and her daughter) and discuss genetic predisposition to bisphosphonate-induced AFFs in the light of literature data.
Objectives: This study aims to compare the efficacy of the wrist splint and the injection of corticosteroid, autologous blood, and hypertonic dextrose in the treatment of lateral epicondylitis (LE).
Patients and methods: A total of 120 patients (43 males, 77 females; mean age: 45.7±7.7 years; range, 18 to 65 years) diagnosed with LE between December 2013 and June 2015 were included in the study and randomized into four groups. The first group was administered 20 mg methylprednisolone acetate + 2 mL 2% prilocaine, the second group 2 mL venous blood + 0.5 mL prilocaine, and the third group 2 mL 30% dextrose + 0.5 mL prilocaine injections. A second injection was administered to the third group one month later. The fourth group was recommended to use only a wrist splint. Pre-treatment and post-treatment evaluations of the patients were carried out at one and six months by the Visual Analog Scale (VAS) in terms of pain, by Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire in terms of functional level, and by the Jamar dynamometer in terms of grip strength.
Results: In all groups, VAS values at one and six months after treatment were found to be lower in comparison to baseline. Except for the splint group, a significant improvement was observed in all three injection groups in terms of grip strength and PRTEE values at six months compared to the baseline values. In the comparison of the groups, no significant difference was observed in terms of improvement in VAS scores and grip strength. While corticosteroid injection was significantly effective in terms of PRTEE pain, function, and total scores only at one month, the autologous injection was effective in terms of PRTEE function and total scores at only six months after treatment. There were no significant differences for splint and prolotherapy groups in terms of PRTEE scores.
Conclusion: Corticosteroid injection, autologous blood injection, and prolotherapy are effective and safe long-term methods in LE treatment.
Psöriatik artrit (PsA) periferik eklemler, omurga ve entezis bölgelerinin kronik inflamatuar artropatisidir. Psöriatik artrit prevelansı psöriazisli hastalarda %7-11, genel toplumda ise %0,04-0,1 arasında bildirilmektedir. Romatoid artrit (RA) ise daha çok el bilek, metakarpofalangeal, proksimal interfalangeal ve metatarsofalangeal eklemleri tutan kronik simetrik inflamatuvar bir artrittir. Romatoid artrit prevelansı %0,2-1 olarak bildirilmektedir. Romatoid artrit ve psöriatik artrit tek başlarına sık görülen romatizmal hastalıklar olmalarına rağmen bu iki hastalığın birlikteliği halen tartışmalı bir konudur ve tanı zorluklarına yol açmaktadır. RA ve PsA hastalıklarının ayırıcı tanısı önemlidir, çünkü klinik, serolojik ve radyolojik olarak birbirlerine benzemesine rağmen patolojilerinin farklılığı farklı klinik sonuçlara yol açabilir. Erken tanı, doğru tedavinin belirlenerek olası eklem hasarını önlemede önemlidir. Bu vakada psöriazis zemininde simetrik poliartrit gelişen ve romatoid artrit ve psöriatik artrit birlikteliği tanısı düşünülen erkek hasta sunulacaktır.
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