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The aim of this study is to evaluate sarcopenia in female patients with Fibromyalgia Syndrome (FMS), according to diagnostic algorithms, in terms of total and regional muscle mass measurements. The study included 60 female patients diagnosed with FMS (mean [M] = 47.78 years, Standard deviation [SD] = 4.72 years) and 30 healthy women (M = 49.8 years, SD = 4.8 years). The ages and anthropometric measurements were noted, and participants evaluated using the Widespread Pain Index, Symptom Severity Scale, Visual Analog Scale, Fatigue Severity Scale, Beck Depression Inventory, International Physical Activity Questionnaire, and the Fibromyalgia Impact Questionnaire. The hand grip strength and gait speed values of the patient group were found to be lower than those of the control group, and the chair stand test value higher than that of the control group. There was a statistically significant difference between the groups (  < 0.01). Two individuals in the patient group were classified as having sarcopenia according to the ISarcoPRM algorithm. No statistically significant difference was found between the patient group and the control group in terms of anterior thigh muscle thickness, sonographic thigh adjustment ratio, and skeletal muscle mass index (  = 0.897,  = 0.829,  = 0.706). The female patients with FMS were dynapenic, which means a loss of muscle function without a loss of muscle mass.

Osteomalacia is a metabolic bone disease characterized by demineralization of the newly formed osteoid in adults. Vitamin D deficiency due to insufficient vitamin D intake, inadequate exposure to sunlight, and malabsorption of vitamin D are the most widespread cause of osteomalacia. Here,we present the case of 18 year old female patient who presented to our hospital with complaints of low back pain. Sacral bone pseudofracture was detected by magnetic resonance imaging due to osteomalacia. Patient was treated with vitamin D.

The incidence of intervertebral disc degeneration (IDD) is 10% in the patients at age 50 but increases up to 60% around 70 years of age.4 These degenerative changes in the lumbar spine are a major etiological factor in the development of LBP and disability in the elderly population.5 Intervertebral disc degeneration is strongly related to LBP, and while it is asymptomatic in most cases, it may give rise to sciatalgia in some cases and to spinal stenosis in the long term, which is an important cause of pain and disability particularly in elderly patients.6-7 The clinical picture in LS patients include discomfort in the lower back, radiating leg pain, and neurogenic intermittent claudication (NIC).8 Lumbar spondylosis diagnosis is made by clinical examination and imaging methods. Detection of degenerative changes in the lumbar X-rays, such as osteophytes, intervertebral narrowing, and subchondral sclerosis, support the diagnosis.9 Magnetic resonance imaging (MRI) is the best imaging tool for the assessment of detailed structural changes in the spinal canal, the ligaments, the discs, and the nerve roots.10 However, in studies examining MRI findings in asymptomatic individuals, it was reported that a significant proportion of patients had bulging, annular tears, facet arthropathies, and it was emphasized that degenerative changes increased with age.11 Weiner et al.12 have pointed to the excessive diagnostic tests in elderly patients with LBP and emphasized unnecessary employment of MRI in most of the patients, which contributed substantially to the increased health costs. Visual Analog Scale (VAS) values for pain during the day (at rest and with movement) and at night, presence of radiating pain, Roland Morris disability questionnaire (RMDQ) for functional status evaluation, straight leg raise test (SLRT) for sciatalgia, deep tendon reflexes (DTRs; as hypoactive, normal, or hyperactive), NIC findings, and motor strength and sensory loss were recorded. According to the MRI reports, 245 (76.8%) had disc hernia, 285 (89.3%) had IDD, 149 (46.7%) had root compression, 256 (80.3%) had osteophytes, and 119 (37.3%) showed SS findings (Table 2).

The objective of this study was to assess the prevalence of fibromyalgia (FM) in patients with episodic migraine and to evaluate the relationship between migraine characteristics and FM. One hundred and eighteen consecutive patients (mean age = 38 years, 75 % women) fulfilling the International Classification of Headache Disorders-II criteria for migraine with ( n  = 22) and without ( n  = 96) aura from an outpatient headache clinic of a university hospital were evaluated. The diagnosis of FM was made based on the 1990 American College of Rheumatology classification criteria. Participants completed some self-administered questionnaires ascertaining sociodemographics, headache severity, frequency and duration, headache-related disability (Headache Impact Test [HIT-6]) and Migraine Disability Assessment Scale, widespread musculoskeletal pain (visual analog scale), depression (Beck depression inventory), anxiety (Beck anxiety inventory), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Assessment of Fatigue), and quality of life (Short Form-36 Health Survey [SF-36]). In patients with FM, the tender point count and the Fibromyalgia Impact Questionnaire were employed. FM was diagnosed in 37 (31.4 %) of the patients. FM comorbidity was equally distributed across patients with and without aura. Severity of migraine headache, HIT-6, and anxiety were especially associated with FM comorbidity. Patients suffering from migraine plus FM reported lower scores on all items of the SF-36. This study indicates that the assessment and management of coexisting FM should be taken into account in the assessment and management of migraine, particularly when headache is severe or patients suffer from widespread musculoskeletal pain.

Abstract We report a case of reactive arthritis following tetanus vaccination. A healthy 55-year-old woman presented with pain and acute swelling of the right knee two days after receiving a tetanus vaccination. Erythrocyte sedimentation rate and C-reactive protein were elevated. Rheumatoid factor and human leukocyte antigen B-27 were negative. Her arthritis improved with the administration of nonsteroidal anti-inflammatory drugs. One week later the knee swelling and pain had settled. Reactive arthritis may occur after tetanus vaccination.

In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease.

Of those, three used cluster sampling,3-5 one intended to reach the entire population living in the study area20 and one did not mention how the sampling procedure was managed.19 Four of those studies were held mainly in coastal urban areas,3-5,19 not taking into consideration the hinterland and rural areas. [...]our study had the advantage of covering both urban and rural areas and also inland Turkey. In doing so, we aimed to capture all the individuals intended to be involved in the study. [...]despite being less costly than face-to-face surveys, telephone surveys might result in lower response rates.21 Our study indicates a prevalence of 0.56% for RA adjusted for the general population aged 16 or over. [...]58% of the individuals involved in our study were females whereas the national census performed in 2000 showed that females constituted 50% of Turkey's population. [...]our study showed that a northsouth gradient of RA across Europe might not exist, compared to the prevalence reported from Northern European countries.12,28 However, a north-south gradient of RA might exist in Turkey.

Objective of this study is to asses the relationship between tender point count (TPC) and the severity of disease in patients with primary fibromyalgia (FM). One hundred and seven female patients with FM diagnosis according to ACR criteria were included to the study. Main outcome measures were fibromyalgia impact questionnaire (FIQ), Beck depression inventory (BDI), visual analog scale (VAS) and tender point assessment. Mean TPC was 14.66 ± 2.50 and mean VAS was 6.6 ± 1.2 cm. Mean total FIQ score and BDI was 62.75 ± 15.57 and 16.17 ± 7.12, respectively. TPC was correlated positively with FIQ and VAS scores. There was no correlation between TPC and age and duration of symptoms. In conclusion, TPC is a simple and noninvasive examination finding that can supply information about the disease severity and the depression in FM.

The first aim is to show if there is a disorder in proprioception in cases with benign joint hypermobility syndrome (BJHS) when compared to healthy subjects. The second aim is to evaluate the effect of proprioception exercise in BJHS cases. To evaluate the proprioceptive sensibility of the knee joint with 40 BJHS and 30 healthy subjects enrolled in the study. Then, cases with BJHS were randomized into two groups; proprioceptive exercises were applied to 15 patients for 8 weeks in clinic and 25 patients were taken as controls. Outcome measures included proprioceptive sensation, AIMS2 and VAS. Proprioception is significantly impaired in cases with BJHS. In BJHS group, significant decreases in VAS levels were detected in cases who did exercise compared with cases who did not, and statistically significant improvements were detected in occupational activity. For this reason proprioception exercises cause decrease in pain and improvement of functional status in BJHS group.

The symptoms are often intermittent and affect target joints (distal and proximal interphalangeal joints, index and middle metacarpophalangeal joints, and thumb base), and the Heberden's nodes, Bouchard's nodes and bony enlargement are the clinical hallmarks of hand OA.6 Radiographic evaluation is widely used to evaluate the structural damage of hand OA. [...]the evidence for the relationship between radiographic hand OA and hand function ranges from none to moderate.9 Symptomatic hand OA is associated with weak grip strength and impaired hand function, and it seems to be mediated by pain.4,10,11 Furthermore, Heberden's and Bouchard's nodes can affect hand function and lead to poor cosmesis.10,12 In the present study, we aimed to determine the clinical, functional, and radiological features of hand OA and to evaluate their relationships in different geographic samples of the Turkish population. The demographic and clinical characteristics of the patients, body mass index (BMI), and dominant hand finger ratio (second to fourth finger length) were evaluated. [...]DHI scores were found to be significantly higher in patients with Bouchard nodes in the fourth finger of the right hand (p = 0.016) and the third (p = 0.033) and fourth fingers (p=0.024) of the left hand.