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Objective: The C-reactive protein/albumin ratio (CAR) has recently emerged as a novel inflammatory biomarker, indicating its potential role in determining inflammation in various disorders. This study aims to investigate the role of CAO in determining disease activity in axial spondyloarthritis (axSpA). Material and Method: This study is a retrospective case-control study. A total of 128 patients with axSpA and 111 age-gender-matched healthy controls were included in the study. Serum albumin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were recorded. CAR was calculated as serum CRP/Albumin. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score-CRP (ASDAS-CRP) scores were used to determine disease activity. Patients were divided into two subgroups based on the BASDAI score: =4 was considered active disease, and <4 was considered an inactive disease. Additionally, axSpA patients were also subdivided into radiographic and non-radiographic disease groups. Results: CAR was significantly higher in axSpA patients compared to healthy controls (1.42 (0.91-4.49) and 0.46 (0.25-0.95), p<0.001, respectively). Similarly, CAO was found to be significantly higher in patients with active disease compared to those with inactive disease (4.61 (2.04-6.87) and 0.977 (0.75-1.52), p<0.001, respectively). CAR showed a significant correlation with CRP, ESR, BASDAI, and ASDAS-CRP (r=0.996, p<0.001; r=0.471, p<0.001; r=0.779, p<0.001, r=0.842, p<0.001, respectively). The area under the curve (AUC) for distinguishing active from inactive disease using CAR was 0.795 (95% confidence interval (CI) 0.714-0.861; p<0.001). Conclusion: CAR correlates highly with disease activity in axSpA. It can potentially be a useful biomarker for determining and monitoring inflammation in axSpA. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Notalgia paresthetica is a clinical pathology that usually occurs with local pain, paresthesia, hyperesthesia, itching and pigmentation increase in the lower scapular region. Etiopathogenesis is unclear, two different mechanisms have been proposed. The first is the local sensory innervation changes in the affected area, the second is the degenerative diseases of the cervical spine or the neuropathy resulting from direct nerve compression. In addition, visserocutaneous reflex mechanisms, activation of neurotoxic mediators are responsible for the pathogenesis of the disease. In addition to local and systemic medical treatments, many physical therapy methods such as superficial and deep heaters, analgesic electrotherapy methods, manipulation and exercise are used in the treatment of notalgia paresthetica. In order to raise awareness in this case series, we wanted to present our case of notalgia paresthetica, which is considered to be rare. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the diagnosis of patients aged 65 years and over in applying to physiotherapy hospitals and to make an evaluation in terms of primary health care delivery. Methods: Our study was carried out by retrospectively reviewing the electronic records of patients aged 65 years and over who applied to the Physiotherapy and Rehabilitation Hospital outpatient clinics between 01 January - 31 December 2016. Results: A total of 3920 patients were included in the study. Of these patients, 2392 (61%) were female and 1528 (39%) were male. According to the diagnoses of patients who received physiotherapy treatment, lumbar diseases were found to be the most common with 17% among physical therapy and rehabilitation diseases. Similarly, the rate of diagnosis with a knee disease was 15.8%, while this rate was 46.4% in all patients. Based on the groups defined in the physiotherapy and rehabilitation diagnosis groups list specified by the health practice communique, the rate of diagnosis of group A was 7.5% (n: 522), the rate of diagnosis of group B was 1.5% (n: 107), and the rate of diagnosis of group C was 22.5% (n: 1556). Conclusion: In primary health care provision, patients should be made aware of their skeletal system complaints. During this process, we think that it is important for family physicians to support the patients to struggle with pain, in terms of raising the quality of life of the patients in this age group. [ABSTRACT FROM AUTHOR]

Low back pain is a disease that may lead to disability and work loss, and the cost of it has high diagnosis and treatment is high cost. Lifetime prevalence of the low back pain is reported to be 84%. Although disc is considered to be the most common pain cause of lumbar spine; depending on the population studied, facet syndrome is estimated to be responsible for 15-40% of chronic low back pain. Lumbar facet syndrome (LFS) is one of the significant causes of chronic low back pain and its prevalence ranges between 5% and 90%. Despite the clinical significance of the disease and a high number of studies available, debates on diagnosis and treatment are still ongoing. In this article the anatomical structures and biomechanics of the lumbar facet joints, as well as the etiopathogenesis, clinical presentation, diagnosis, diagnosis and treatment of LFS were reviewed. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is defined as an inflammatory arthritis of the spine, always involving the sacroiliac joints. Cervical column and atlantooccipital articulation mobility are reduced, and in severe cases, the cervical vertebrae become fixed in a flexed position. This portion of the spine is also the most susceptible to fracture, particularly in hyperextension, an event that could lead to damage to the cervical spinal cord during maneuvers to manage the airway. Clinical judgment is critical regarding the timing and selection of the method for airway intervention. In our case of AS with fixed flexion deformity of the thoracic and thoracolumbar spine, supine position and head extension were not possible. We present an instance of successful use of a flexible fiberoptic intubation with light sedation and local block. A 48-year-old female was scheduled for right salpingo-oophorectomy because of ovarian cyst. She had been suffering from extensive AS, with the cervical spine markedly fixed in anterior flexion. Mallampati score was 3, and she could not open her mouth widely (20 mm when fully open) because of ankylosis of the jaw. We used a fiberoptic tracheal intubation for anesthesia in this awake patient, with remifentanil infusion and local mucosal anesthesia. The whole procedure was uneventful and smooth. In conclusion, flexible fiberoptic nasotracheal intubation in patients with severe AS is a safe alternative for successful airway management. [ABSTRACT FROM AUTHOR]

Objectives: Aim of this study was to investigate serum and erythrocyte membrane total sialic acid levels in patients with rheumatoid arthritis and ankylosing spondylitis and demonstrate any correlation between total sialic acid and disease activity score and other inflammation variables. Material and methods: Serum total sialic acid and erythrocyte membrane sialic acid levels were measured in 24 rheumatoid arthritis, 19 ankylosing spondylitis patients and 24 healthy controls as well as serum C-reactive protein, anticyclic citrullinated peptide, rheumatoid factor, alkaline phophatase and erythrocyte sedimentation rate and compared with activity of the diseases. Results: Serum total sialic acid levels of patient groups were statistically higher than control group (p<0.05). Serum total sialic acid levels in rheumatoid arthritis were significantly higher than the ankylosing spondylitis patients (p<0.05). There was no significant difference between the groups for erythrocyte membrane sialic acid. Significant correlation was found between serum total sialic acid and serum C-reactive protein in both groups (r=0.411, r=0.825); correlation between serum total sialic acid and erythrocyte sedimentation rate was found only in ankylosing spondylitis group (r=0.515). There was a significantly negative correlation between erythrocyte membrane sialic acid and serum C-reactive protein in ankylosing spondylitis group (r =-0.570). Conclusion: Serum total sialic acid is a useful diagnostic tool as an inflammatory parameter and can be used in the differential diagnosis of rheumatoid arthritis and ankylosing spondylitis. [ABSTRACT FROM AUTHOR]

Scheuermann kyphosis is defined as thoracic kyphosis with an angle greater than 45° in association with wedging of an angle greater than 5° in 3 consecutive vertebrae. Hyperextension casts and bracing are used in the treatment of patients with incomplete skeletal maturation. However, conservative treatment is not efficient in kyphotic patients with an angle greater than 70°. In this study results of the patients performed posterior surgical treatment due to Scheuermann kyphosis between 2005 and 2009 were evaluated. In conclusion, fusion performed with posterior transpedicular screws is one of the alternative choices in the surgical treatment of Scheuermann kyphosis (>70°). [ABSTRACT FROM AUTHOR]

Published reports of spontaneous radiological regression in lumbar disc herniations have been increased with introduce of the CT and MRI into the clinical practice. In published case reports, spontaneous radiological regression well correlated with both clinical and radiological status of the patients. In some studies, it has been reported that disc showed no change, or it increased. However, there is no report about the development of any sequel in radiologically regressed lumbar disc herniations such as foraminal stenosis.In this report, we are presenting two cases that showed decreases in lumbar discs radiologically, however they developed neural foraminal stenosis as a sequel. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the Turkish translation of the patient version of the Assessment in Spondyloarthritis International Society (ASAS) and European League Against Rheumatism (EULAR) recommendations for the management of ankylosing spondylitis (AS) by the patients. Material and Methods: Twelve members of the Ankylosing Spondylitis Patient Society of Turkey participated in the study. All were patients suffering from AS and all items of the recommendations were evaluated for the exact Turkish wording, meaning and comprehensibility by Turkish AS patients. All items were discussed and scored by the patients. Results: The median age of the 12 patients (4 female and 8 male) was 39.5 and disease duration was 11.5 years. The median Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index were 4.0 and 3.42, respectively. Patients were agreed on each of the 10 items with a mean rate of >80%, and scored the overall recommendations with a mean score of 9.83±0.39. Conclusion: The patient version of the ASAS/EULAR recommendations for the management of AS has been successfully translated into Turkish and all of the patients reached an overall agreement on these recommendations. Treatment guidelines or recommendations that were composed using a medical language that could not be clearly understood by the patients should be translated into common vernacular in order to disseminate knowledge and maintain the patients' participation. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine pulmonary function in ankylosing spondylitis (AS) patients and to assess the relationship with clinical parameters. Material and Methods: A total of 30 patients with definite AS (Group 1) and 20 age-matched healthy controls (Group 2) were recruited for the study. Patients and healthy controls were assessed according to visual analog scale (VAS) pain, 6 minute walk test (6MWT), chest expansion, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Bath Ankylosing Spondylitis Functional Index (BASFI). Pulmonary function was assessed by forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and vital capacity (VC). Results: There was no statistically significant difference in age or body mass index between groups (p>0.05). There were significant differences in VAS pain, chest expansion, BASDAI and BASFI scores and pulmonary function parameters FVC, FEV1, VC and 6MWT between groups (p<0.05). There were significant correlations between all pulmonary function parameters and clinical and functional measures. Conclusion: Based on these results, we conclude that there is a correlation among functional performance, pulmonary capacities and clinical parameters in AS patients. [ABSTRACT FROM AUTHOR]

Objective: Pain and stiffness disturb the psychological status and quality of life in ankylosing spondylitis (AS) patients, which may be further deteriorated by pulmonary involvement. Therefore, detection of pulmonary involvement in AS patients is important. In this study, we aimed to detect pulmonary involvement in AS patients and to assess the effects of pulmonary involvement on Bath indexes, quality of life and psychological symptoms. Material and Methods: The study included 26 AS patients (mean age: 47.5±10.8 years). Pulmonary status of the patients was assessed by spirometric measurements and radiographic methods (chest X-ray, high resolution computerized tomography [HRCT]); clinical status was assessed by Bath indexes (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Bath Ankylosing Spondylitis Functional Index [BASFI], Bath Spondylitis Metrology Index [BASMI], Bath Ankylosing Spondylitis Radiology Index [BASRI]); quality of life was assessed by Nottingham Health Profile-1 (NHP) and St. George Respiratory Questionnaire (SGRQ); and psychological symptoms were assessed by Beck Depression Scale (BDS). Results: Respiratory function tests were impaired in 15.4% of the patients (n: 3/1, restrictive/obstructive). HRCT revealed pathologic findings in 20.9% of the patients (n: 5). A negative correlation was detected between forced expiratory volume in 1 second (FEV1%) and BASFI (r=-0.56, p<0.01). No significant correlation was observed between the other respiratory function tests and HRCT, duration of disease, Bath indexes (BASDAI, BASFI, BASMI, BASRI), NHP, SGRQ, and BDS (p>0.05). Conclusion: Our study showed that pulmonary involvement may be observed among non-smoker AS patients with longer duration of disease; however, pulmonary involvement is not related with clinical status, quality of life or psychological symptoms. [ABSTRACT FROM AUTHOR]

Strontium ranelate is a new agent developed for the management of post-menopausal osteoporosis. It has dual action on bone metabolism in that it stimulates the formation of new bone tissue and decreases bone resorption. There are evidences that CaSR-dependent and -independent pathways mediate the beneficial effects of strontium ranelate. It was found that strontium ranelate reduces vertebral, nonvertebral and major nonvertebral fractures and it is well tolerated over 1, 3, 4, and 5 years in post-menopausal osteoporosis. A reduction in vertebral and nonvertebral fracture risk was also shown in senile osteoporosis, and it was well tolerated. It has been suggested that strontium ranelate is able to reduce the progression of spine osteoarthritis. Here, we review strontium ranelate's mechanism of action, results of efficacy and tolerability studies and its place in the management of post-menopausal osteoporosis. [ABSTRACT FROM AUTHOR]

with ankylosing spondylitis (AS). There is no avaible data for the indications of bone mineral density (BMD) measurement related to osteoporosis diagnosis at AS patients. The aim of this study is to investigate the relationship between Bath indexes and BMD in patients with AS. Materials and Methods: 45 male AS patients (mean age: 46.96±13.58 years) and 41 healthy male controls (mean age: 48.93±6.86 years) were enrolled in the study. Patients with AS were evaluated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Spondylitis Metrology Index (BASMI) and Bath Ankylosing spondylitis Radiology Index (BASRI). The BMD of AS and control group patients were assessed at hip (femoral neck, Ward's triangle and femur trochanter) and lumbar area. Results: We have found a significant difference at the femoral ward triangle and lomber spine BMD and T scores in favour of AS patients (p<0.05). BASMI scores were negatively correlated with femoral neck and femoral ward triangle (p<0.05). BASDAI, BASFI scores were not correlated with BMD and T scores of any measured regions. Conclusion: We found that femur ward triangle may be appropriate to evaluate bone loss in patients with AS. BASMI score is a useful tool to determine BMD in patients with AS. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the sex, age, follow-up time, mean frequency of uveitis, and accompanying eye examination findings of patients diagnosed with uveitis associated with arthritis. Materials and Methods: Thirty-one patients with uveitis associated with arthritis that were followed-up in the Turkish Ministry of Health Ankara Ulucanlar Eye Education and Research Hospital Retina Clinic between 2000 and 2006 were retrospectively evaluated in this study. A complete ophthalmological examination including visual acuity, intraocular pressure with applanation tonometry, biomicroscopic examination findings, and dilated pupil examination of the posterior segment were evaluated at baseline and during the follow-up period. Results: There were 9 females (29.03%) and 22 males (70.96%). The average age of patients was 40.03 years (6-66 years). Mean time of diagnosis was 3.22 years (1-8 years). Mean follow-up period was 2.43 years (1-7 years). Forty-one eyes of 31 patients were involved. Twenty-one patients had unilateral involvement and 10 had bilateral involvement. The etiologic causes were ankylosing spondylitis in 32 eyes (78.04%), juvenile idiopathic arthritis in 7 (17.07%), and psoriatic arthritis in 2 (4.87%). The anterior segment findings were posterior synechiae in 16 eyes (39.02%), cataract in 9 (21.95%), and band keratopathy in 2 (4.87%). The only posterior segment finding was vitreous condensation in 1 eye (2.43%). All the patients were treated with medical therapy devoted to the etiologic cause. No patient was treated with surgical therapy. Conclusion: Based on the results obtained in this series, ankylosing spondylitis was the most common cause of uveitis associated with arthritis. The same anterior segment findings and complications were seen in these types of uveitis. In general, the mid-term prognosis is good in these cases. [ABSTRACT FROM AUTHOR]

Brucellosis is zoonotic infection transmitted from animals to human who caused a disease among people whom consume milk products or concern with diary factories. As well as the other systems brucellosis leads to musculoskeletal symptoms which vary from 2 to 53%. In this review; the clinical findings, diagnose and treatment of musculoskeletal involvement such as sacroiliitis, spondylitis and peripheral arthritis of brucellosis are overviewed by the literature. [ABSTRACT FROM AUTHOR]

Copyright of Romatizma/Rheumatism is the property of Turkish League Against Rheumatism / Turkiye Romatizma Arastirma ve Savas Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mal de Meleda is an autosomal recessively inherited, special type of palmoplantar keratoderma. In this report, we present a Mal de Meleda patient who had an osteomyelitis which was thought to be a complication of the disease. Twelve-year-old girl was brought to our out-patient clinics with the complaint of hyperemia and swelling in her left elbow. In her physical examination; there was an edema, increased local heat, hyperemia and motion tenderness in elbow and proximal forearm. In both palmar and plantar areas, there was a diffuse yellowish-white hyperkeratosis, maceration, patchy fissures and red eroded areas. Deep aspiration to the elbow revealed purulent material and patient was treated surgically with the diagnosis of subacute osteomyelitis. Thick and commonly macerated keratin layer due to hyperhydrosis is a suitable place for dermatophytic infections in Mal de Meleda. However, secondary bacterial infections are not reported. In our case, we considered the lesions, fissures and eroded skin, is a gate for bacterial inoculation to the deep tissue resulting with osteomyelitis. [ABSTRACT FROM AUTHOR]

Brucellosis is a systemic infection in which any organ or system of the body can be involved. The most common osteoarticular involvements are sacroiliitis, spondylitis and peripheral arthritis. However, bursitis is a rarely observed osteoarticular manifestation of brucellosis. In this article, a case of brucellosis with spondylodiscitis, bursitis and epididymo-orchitis is presented. [ABSTRACT FROM AUTHOR]

Psoriatic arthritis (PsA) is chronic inflammatory rheumatic disease characterized by of peripheral arthritis, enthesitis, spondylitis and psoriasis. The mean age at onset of PsA is in the range of 30-50 years. In clinically, approximately 17% of patients develop arthritis before the onset of psoriasis. Osgood Schlatter syndrome presents in growing children (boys, 12-15 years; girls, 8-12 years) with local pain, swelling and tenderness over the tibial tuberosity. In this paper, Osgood Schlatter syndrome causing bilateral knee pain during the fallow-up of a patient with atypical PsA is reported. [ABSTRACT FROM AUTHOR]

Cervical spine involvement occurs in over half of the patients with rheumatoid arthritis. The destruction of the spine ranges from minimal subluxation to atlantoaxial dislocation and compression of the spinal cord and brainstem, and hence may result in sudden death. In this paper, we present a case of seronegative rheumatoid arthritis with cervical involvement, and we review cervical involvement in view of the related literature. [ABSTRACT FROM AUTHOR]

Vacuum phenomenon is the accumulation of gas in the intervertebral region. This gas image is seen as a radiolucent area in the synovial space, intervertebral discs and vertebrae. The majority of the gas is nitrogen. Intervertebral disc degeneration is often accused on etiology. The mechanism is unknown. Vacuum phenomenon can especially be seen from radiography and spine tomography in elderly patients with disc degeneration who are admitted to the emergency room because of back pain. [ABSTRACT FROM AUTHOR]