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    Clinical and laboratory features of patients with musculoskeletal brucellosis
    (Turkiye Klinikleri, 2005) Aydin, Gülümser; Keleş, İlayda Ceren; Atalar, Ebru; Ayaşlioğlu, Ergin; Tosun, Aliye; Orkun, S.
    Objective: To evaluate the demographic, clinical and laboratory features of patients with musculoskeletal brucellosis in urban and rural areas of Kirikkale, Turkey. Material and Methods: Twenty-eight patients with the diagnosis of musculoskeletal brucellosis were included in the study. All patients were questioned for demographic characteristics, duration and characteristics of complaints and possible source of infection. The findings of detailed systemic and musculoskeletal examinations were noted. Routine blood chemistries, complete blood count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, antinuclear antibody, blood culture and standard tube agglutination tests were carried out. Radiographs of the sacroiliac joints and lumbosacral spine of all patients and, if required, radiographs of peripheral joints were evaluated. Magnetic resonance imaging was performed on those in whom deep joint involvement was suspected clinically and radiographically. Results: Patient mean age was 39.4±14.4 yr, mean duration of disease was 10.1 ± 12.7 yr, and 64.3% of the patients were male. The most frequent symptom was arthralgia (85.7%), and the most prevalent sign was splenomegaly (32.1%). Blood cultures were positive in 39.3% of the patients. Peripheral arthritis had the highest incidence with a rate of 71% in joint manifestations, and the most frequent involvement sites were hip and knee with a ratio of 35%. Sacroiliitis was detected in 32% and was unilateral in 89% of the patients. Spondylitis was found in 14% of the patients, most frequently in lumbar segments (75%). Each musculoskeletal involvement site in terms of all parameters were compared with the others and only the sacroiliac test in the sacroiliitis group and age, vertebral tenderness with percussion and the presence of painful spinal movements in spondylitis group were significantly different from the others (p<0.05). Conclusion: Peripheral joints are the most common articular involvement sites in patients with musculoskeletal brucellosis in our region. Specific sacroiliac joints tests may serve as guides to sacroiliitis. Spinal involvement should be kept in mind in elderly patients with brucellosis, particularly when spinal movements are painful or tenderness is elicited with percussion over the spine. Brucellosis should be included in the differential diagnosis of patients with spinal or peripheral joint pain and in those presenting with complaints due to soft tissue rheumatism. Copyright © 2005 by Türkiye Klinikleri.
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    Heterotopic ossification following stroke: A report of two cases and review of the literature
    (2002) Keleş, İlayda Ceren; Kutay Ordu, N.; Aydın, Gülümser; Akyüz, Müfit
    Heterotopic ossification (HO), frequently encountered in patients with spinal cord injury, traumatic brain injury, burns and total hip arthroplasty, is the formation of new bone in periarticular soft tissues. It is less common in stroke patients. Immobilization is a major factor in the formation of HO in neurologic disorders. In addition to early diagnosis and treatment, beginning of exercise therapy in patients with limited mobility is essential to reduce morbidity related to HO. A general review of the literature and two HO cases following stroke are presented in this article.