Safiye Tuncer

Disability in ankylosing spondylitis

PURPOSE This study was designed to examine the functional loss in ankylosing spondylitis and explore the relationship between disability and various factors such as age, disease duration, disease activity, spinal mobility, chest expansion, peripheral joint involvement, radiological changes, and psychosocial well-being. METHOD Forty-two patients were included in this cross-sectional study. RESULTS The results showed that 37 patients had mild to moderate disability, two patients had severe disability, and three patients did not report any functional loss. Spearman correlation analyses showed that disability was strongly correlated with spinal mobility measures, disease activity measures, and disease duration. Also, patients with peripheral joint involvement had greater disability. When the predictive effect of five independent variables was studied by multiple regression analysis, it was found that the most powerful predictors of functional loss in AS patients were cervical rotation, modified Schobers test, and pain. CONCLUSIONS These data suggest that functional consequences of AS are constituted by multiple impairments and each needs to be managed by an integrated physiatric approach.

Trace element and magnesium levels and superoxide dismutase activity in rheumatoid arthritis

It has been suggested that reactive oxygen metabolites and trace elements play some role in the etiology and pathogenesis of rheumatoid arthritis (RA). Superoxide dismutase (SOD) is believed to exert an important protective role against oxygen toxicity. The aim of the study was to investigate the probable changes in the levels of trace elements and SOD activity in RA. Plasma and erythrocyte copper, zinc, and magnesium levels and erythrocyte SOD activity were measured in groups of controls and RA cases. Significantly increased erythrocyte SOD activity was found in RA patients in comparison with controls(p < 0.0001). A rise in erythrocyte Zn level(p < 0.0001) and plasma Cu level(p < 0.0001) and a decrease in erythrocyte Cu level(p < 0.05) and plasma Zn level(p < 0.05) were obtained in RA patients when compared to controls. Plasma and erythrocyte Mg levels of the RA patients showed slight and statistically insignificant reductions when compared to controls(p > 0.05). In RA patients, there were positive correlations between erythrocyte SOD activity and Mg level (r = 0.4345,p < 0.01) and between erythrocyte Zn level and plasma Cu level(r = 0.4132,p < 0.01). There were negative correlations between erythrocyte SOD activity and plasma Zn level(r =-0.3605,p < 0.05) and between plasma Zn level and erythrocyte Cu level(r =-0.4578,p < 0.01) in RA patients.

Neuropathic arthropathy caused by Arnold–Chiari malformation with syringomyelia

We report a case of neuropathic arthropathy caused by Arnold–Chiari malformation with syringomyelia, with details of the clinical and radiologic aspects. The patient had pain and stiffness in his left upper limb. MRI of the left shoulder revealed neuropathic arthropathy. Upon examination, his left elbow also had the characteristic findings for neuropathic arthropathy. Examination of the spinal cord by MRI confirmed Arnold–Chiari malformation associated with syringomyelia. Neuropathic arthropathy requires evaluation of the spinal cord to assess for occult causal lesions.

Osteoblastoma of the lumbar spine as a cause of chronic low back pain.

Abstract. We report a case of osteoblastoma in the uncommon location of the L5 lumbar vertebra, detailing the clinical and radiologic aspects. Although the plain radiographs of the patient were normal, computed tomographic scans of the lumbar region confirmed the diagnosis of osteoblastoma or osteoid osteoma of the L5 vertebra. The patient was referred to the orthopedic department for operation. Histologic examination revealed osteoblastoma of the L5 vertebra. Following surgery, the patients pain resolved completely. Although osteoblastoma is extremely rare in the spine, it should be included in the differential diagnosis as a cause of chronic back pain, especially in young males with painful scoliosis and/or radicular-type leg pain. The tumor is often not readily apparent on plain radiographs. Therefore, advanced radiological investigation is necessary to establish the correct diagnosis.