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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. © 2021 Turkish Society of Physical Medicine and Rehabilitation. All rights reserved.

The superior cluneal nerve (SCN) is a sensory nerve known to be originated from the dorsal rami of the lower thoracic and lumbar nerve roots. One of the overlooked causes of low back pain (LBP) is the SCN Entrapment Neuropathy (SCNEN). SCNEN may also be associated with SCN stretching due to lumbar movement and the poor body posture through an increase in the paravertebral muscle tonus. A 59-year-old female patient presented with chronic LBP localized on the right iliac crest and radiating to the right buttock, groin, and leg. She had increased lumbar lordosis and anterior pelvic tilt. She had a tender point over the right iliac crest, and the pain was radiating to the buttock and posterolateral thigh (Tinel sign +). She was diagnosed with lower crossed syndrome and SCNEN, and a therapeutic nerve block was performed. Clinicians should consider SCNEN as a possible diagnosis of LBP.

The superior cluneal nerve (SCN) is a sensory nerve known to be originated from the dorsal rami of the lower thoracic and lumbar nerve roots. One of the overlooked causes of low back pain (LBP) is the SCN Entrapment Neuropathy (SCNEN). SCNEN may also be associated with SCN stretching due to lumbar movement and the poor body posture through an increase in the paravertebral muscle tonus. A 59-year-old female patient presented with chronic LBP localized on the right iliac crest and radiating to the right buttock, groin, and leg. She had increased lumbar lordosis and anterior pelvic tilt. She had a tender point over the right iliac crest, and the pain was radiating to the buttock and posterolateral thigh (Tinel sign +). She was diagnosed with lower crossed syndrome and SCNEN, and a therapeutic nerve block was performed. Clinicians should consider SCNEN as a possible diagnosis of LBP.

Background: Upper and/or low back pain are common in medical secretaries. The aim of this study is to compare the curvature and mobility of the spine; disability and quality of life (QoL) of medical secretaries with or without upper or low back pain.Materials and Methods: One hundred eleven medical secretaries working in the same hospital were included in the study. Medical secretaries were divided into two groups such as “with and without back pain”; and two other groups “with and without low back pain”. The curvature and mobility of the spine in the sagittal plane was measured using a non-invasive instrument called "Spinal Mouse™". The measurements were repeated while standing and in a sitting position.The Visual Analogue Scale (VAS) was used to assess pain; the Oswestry Disability Scale (ODS) was used to assess functionality; and the Nottingham Health Profile (NHP) was used to assess QoL.Results: The mean age of the medical secretaries (75 female/36 male) included in the study was 30.73±5.74 years. Mean VAS score of 51 secretaries with back pain was 5.47±2.67; mean VAS score of 63 secretaries with low back pain was 5.52±2.66. The thoracic kyphosis angles of the secretaries with back pain measured while sitting and standing were higher than that of the secretaries without back pain (p˂0.032, p˂0.001). There was no difference between the two groups in terms of thoracic vertebra mobility measured while sitting and standing. There was a difference between the two groups between NHP-total, NHP-energy, NHP-pain, NHP-emotional reactions and NHP-physical mobility subgroups (p˂0.001, p=0.001, p˂0.001, p=0.001, p=0.001). The lumbar lordosis angle of the secretaries with low back pain measured in standing position was lower than those without low back pain (p ˂0.001). There was no difference between the lumbar lordosis angle measured in the sitting position between the two groups in terms of lumbar vertebra mobility measured in the sitting position and while standing. There was a difference between ODS, the subgroups of NHP-total, NHP-energy, NHP-pain and NHP-physical mobility between the two groups (p˂0.001, p=0.025, p=0.042, p=0.039, p=0.019).Conclusions: Although there was no difference in spinal mobility measured by using Spinal Mouse™; it was observed that in the secretaries with back pain, there was an increase in the kyphosis of thoracic spine and there was a decrease in the lordosis of lumbar spine in those with low back pain. The presence of upper and low back pain negatively affects functionality and QoL., Amaç: Tıbbi sekreterlerde sırt ve/veya bel ağrısı sık görülmektedir. Bu çalışmanın amacı, sırt veya bel ağrısı olan sekreterler ile olmayan sekreterlerin omurga eğriliği, omurga hareketliliği, disabilite ve yaşam kalitesi düzeylerini karşılaştırmaktır. Materyal ve Metod: Çalışmaya aynı hastanede çalışan 111 tıbbi sekreter dahil edildi. Tıbbi sekreterler sırt ağrısı olan ve olmayan olarak iki gruba; bel ağrısı olan ve olmayan olarak diğer iki gruba ayrıldılar. Omurganın sagittal düzlemdeki şekli ve hareketliliği “Spinal Mouse™” isimli non-invaziv bir alet kullanılarak ölçüldü. Ölçümler ayakta dururken ve oturma pozisyonunda ayrı ayrı tekrarlandı. Ağrı şiddeti Vizüel Analog Skala (VAS) ile; fonksiyonel durum Oswestry Disabilite Ölçeği (ODÖ) ile; yaşam kalitesi ise Notthigham Sağlık Profili (NSP) kullanılarak değerlendirildi. Bulgular: Çalışmaya dahil edilen tıbbi sekreterlerin (75 kadın/36 erkek) yaş ortalaması 30.73±5.74 yıl idi. Sırt ağrısı olan 51 sekreterin VAS ortalaması 5.47±2.67; bel ağrısı olan 63 sekreterin VAS ortalaması 5.52±2.66 idi. Sırt ağrısı olan sekreterlerin oturur pozisyonda ve ayakta iken ölçülen torakal kifoz açısı, sırt ağrısı olmayan sekreterlere göre daha yüksekti (p˂0.032, p˂0.001). Her iki grup arasında oturur pozisyonda ve ayakta iken ölçülen torakal vertebra hareketliliği açısından anlamlı fark yoktu. İki grup arasında NSP-total, NSP-enerji, NSP-ağrı, NSP-duygusal reaksiyonlar ve NSP-fiziksel hareketlilik alt grupları arasında anlamlı fark vardı (p˂0.001, p=0.001, p˂0.001, p=0.001, p=0.001). Bel ağrısı olan sekreterlerin ayakta duruşta ölçülen lomber lordoz açısı, bel ağrısı olmayanlara göre daha düşüktü (p˂0.001). Her iki grup arasında oturur pozisyonda iken ölçülen lomber lordoz açısı ile oturur pozisyonda ve ayakta iken ölçülen lomber vertebra hareketliliği açısından anlamlı fark yoktu. İki grup arasında ODÖ, NSP-total, NSP-enerji, NSP-ağrı ve NSP-fiziksel hareketlilik alt grupları arasında anlamlı fark vardı (p˂0.001, p=0.025, p=0.042, p=0.039, p=0.019). Sonuç: Spinal Mouse™ kullanılarak yapılan ölçümlerde omurga hareketliliğinde fark olmamasına rağmen; sırt ağrısı olan sekretelerde torakal omurgada kifoz artışı, bel ağrısı olanlarda da lomber omurgada lordoz azalması olduğu görülmüştür. Sırt ve bel ağrısının varlığı fonksiyonel durumu ve yaşam kalitesini olumsuz etkilemektedir.

WOS: 000404688300008 Cervical spondylotic myelopathy is a neurological disorder caused by degenerative changes in the cervical spines emerging from spinal channel narrowing. This is the most common reason of spastic tetraplegia in later phases of life. In this case report, an elderly male patient with subclinical symptoms and having cervical spondylotic myelopathy causing sudden spastic tetraplegia was presented in the light of current literature.

Purpose: Evaluation of quality of life in fibromyalgia syndrome (FMS).Materials and Methods: A total of 109 female with FMS and 101 healthy female controls were included in the study. SF-36(short form) questionnaire, which includes data on physical health, physical role difficulty, pain, social function, mental health, emotional role difficulty, vitality and general health, was applied to both groups. Age, , comorbidity, smoking, alcohol use, drug use and fibromyalgia impact questionnaire (FIQ) were recorded in FMS. The normal distribution of the variables was measured with the Kolmogorov-Smirnov test. Independent sample t-test, Mann-whitney u test were used for the analysis. Spearman correlation analysis was used for correlation analysis.Results: The age of two groups did not differ significantly (p > 0.05). In the FMS group, SF-36 physical function score, physical role difficulty score, pain score, social function score, mental health score, emotional role difficulty score, vitality score and overall health score were found to be significantly lower than the healthy controls(p ˂ 0.05).There was a significant negative correlation between FIQ and SF-36 physical function score, mental health score, vitality score and overall health score(p ˂ 0.05). There was no significant correlation between FIQ score and SF-36 physical role difficulty, pain , social function and emotional role difficulty scores(p > 0.05).Conclusion: FMS is a common musculoskeletal disorder. Quality of life in FMS was found to be lower than healthy controls. Furthermore, there was negative correlation between the FIQ score and SF-36. FMS affects quality of life negatively., ÖZAmaç: Fibromiyalji Sendromlu (FMS) hastalarda yaşam kalitesinin değerlendirilmesidir.Araçlar ve Yöntem: Çalışmaya hastanemiz Fiziksel Tıp ve Rehabilitasyon polikliniğine 01.01.2016 ile 31.12.2016 tarihleri arasında başvuran 2010 Amerikan Romatizma Cemiyeti tanı kriterlerine göre FMS tanısı almış 109 kadın ve 101 sağlıklı kadın kontrol dahil edildi. Her iki gruba fiziksel fonksiyon, fiziksel rol güçlüğü, ağrı, sosyal fonksiyon, ruhsal sağlık, emosyonel rol güçlüğü, vitalite, genel sağlık ile ilgili veriler bulunduran SF-36 (kısa form) anketi her iki gruba uygulandı. FMS’li hastaların yaş, , komorbidite, sigara ile alkol kullanımı, ilaç kullanımı ve fibromiyalji etki anketi (FIQ) kaydedildi. Değişkenlerin normal dağılıp dağılmadığı Kolmogorov-Smirnov test ile ölçüldü. Nicel bağımsız verilerin analizinde bağımsız örneklem t test, Mann-whitney u test kullanıldı. Korelasyon analizinde spearman korelasyon analizi kullanıldı.Bulgular: Her iki grupta hastaların yaşları anlamlı farklılık göstermemiştir(p > 0.05). FMS grubunda SF-36 fiziksel fonksiyon skoru, fiziksel rol güçlüğü skoru, ağrı skoru, sosyal fonksiyon skoru, ruhsal sağlık skoru, emosyonel rol güçlüğü skoru, vitalite skoru, genel sağlık skoru sağlıklı kontrolden anlamlı olarak daha düşük olarak tespit edilmiştir(p ˂ 0.05). FIQ skoru ile SF-36 fiziksel fonksiyon skoru, ruhsal sağlık skoru, vitalite skoru, genel sağlık skoru arasında anlamlı negatif korelasyon gözlenmiştir(p ˂0.05). FIQ skoru ile SF-36 fiziksel rol güçlüğü skoru, ağrı skoru, sosyal fonksiyon skoru, emosyonel rol güçlüğü skoru arasında anlamlı korelasyon gözlenmemiştir(p > 0.05).Sonuç: FMS sık görülen kas iskelet sistemi hastalıklarındandır. FMS’de yaşam kalitesi sağlıklı kontrolden düşük olarak bulunmuştur. Ayrıca FIQ skoru ile SF-36 arasında negatif korelasyon bulunmuştur. FMS, yaşam kalitesini olumsuz olarak etkilemektedir.

ÖZGebelikle ilişkili intrakranial lezyonlar nadir olarak görülmektedir ancak, mortalite oranı yüksektir. Olguların çoğu intrakranialkanama, intraserebral hemoraji, subaraknaoid kanama, infarkt ve venöz trombozdur. Geri kalanı ise preeklampsi ile ilişkiliensefalopatidir. Hellp sendromu; hemoliz, yükselmiş karaciğer enzimleri ve düşük plateletlerden ismini almıştır. HELLPsendromunun % 25’e varan mortalite oranı raporlanmıştır. Bu yazıda hemiparaziye neden olan HELLP sendromlu bir olgununistenen rehabilitasyon sonuçları sunulmaktadır., Intracranial lesions associated with pregnancy are rare, but mortality rates are high. Most of the events are intracranial hemorrhage,intracerebral hemorrhage, subarachnoid hemorrhage, infarction and venous thrombosis. The remainder is encephalopathy associatedwith preeclampsia. HELLP syndrome is presented with hemolysis, elevated liver enzymes and low platelets. Mortality was reportedup to 25 % in HELLP syndrome. In this paper we present desirable rehabilitation outcomes of hemiparesis caused by HELLPsyndrome.