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Öğe 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.Öğe Cricoarytenoiditis in rheumatoid arthritis: Radiologic and clinical study(B C Decker Inc, 2003) Bayar, N.; Kara, S.A.; Keles, I.; Koç, C.; Altinok, D.; Orkun, S.The cricoarytenoid (CA) joint involvement in rheumatoid arthritis (RA) is not uncommon. In this study, clinical assessment, laryngeal endoscopy, and high-resolution computed tomography (HRCT) were used in 15 patients with RA to evaluate the diagnostic criteria of CA joint involvement. Symptoms owing to CA joint involvement were present in 66.6% of the patients. The frequency of involvement was 13.3% on laryngeal endoscopy but 80.0% with HRCT assessment. The most common HRCT findings were CA prominence (46.6%), density and volume changes (46.6%), and CA subluxation (39.9%). In some of the patients, soft tissue swelling (20%) near the CA joint and narrowing in the piriform sinus (33.3%) were also observed. Radiologic abnormalities related to CA joint involvement generally precede clinical symptomatology. Therefore, HRCT evaluation may be a useful method in the assessment of CA joint involvement in RA patients to exclude possible causes of laryngeal signs and symptoms.Öğe Temporomandibular joint involvement in rheumatoid arthritis: A radiological and clinical study(Taylor & Francis Ltd, 2002) Bayar, N.; Kara, S.A.; Keleş, I.; Koç, M.C.; Altinok, D.; Orkun, S.Temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) is not uncommon. In this study a questionnaire, clinical assessment, and high resolution computerized tomography (HRCT) were used in 15 patients with rheumatoid arthritis to evaluate the diagnostic criteria of TMJ involvement. Symptoms due to TMJ involvement were present in 33.3% of the patients. Frequency of involvement was 40.0% on clinical assessment but 86.6% with HRCT assessment. The most common HRCT findings were decreases in the joint space (33.3%) mandibular subchondral cysts (23.3%), temporal subchondral cysts (23.3%), degeneration (23.3%), shape (13.3%) and height (13.3%) anomalies of the mandibular condyle, condylar head resorption (13.3%), erosion of the mandibular condyle (13.3%), and demineralization (13.3%). All patients with positive clinical findings also had positive HRCT patients, there were no symptoms or clinical findings implying TMJ findings. In seven (46.7%) of the involvement; however, they had positive results on HRCT evaluation. The HRCT findings may be the initial sign of TMJ involvement in patients with rheumatoid arthritis. In conclusion, it is suggested that RA patients with the suspicion of TMJ involvement should undergo HRCT evaluation, because HRCT findings may precede the clinical findings.Öğe Two clinical problems in elderly men: Osteoporosis and erectile dysfunction(Taylor & Francis Inc, 2005) Keleş, Işık; Aydın, Gülümser; Orkun, S.; Basar, M. Murad; Batislam, E.Seventy-six of 108 random men aged 50 years or over were evaluated for erectile dysfunction with interviews of patients using the International Index of Erectile Function Form and minimal evaluation. Serum hormone concentrations were measured. Bone mineral density was measured using dual energy x-ray absorptiometry. Hormone levels did not show significance in terms of erectile dysfunction or bone mineral density results. Erectile dysfunction was determined in 57 (75%) of 76 palients. Ten (13.2%) patients had osteoporosis and 45 (59.2%) had osteopenia at the bone mineral density measurements. The distribution of bone mineral density groups relating to erectile dysfunction did not show significance. The frequencies of osteoporosis and erectile dysfunction increased with age, but the association of these conditions seems to be independent of each other and hormonal changes appear not to be the major determinants for both conditions in elderly men.
