Ama: Dual enerji X-n absorbsiyometri tetkiki esnasnda hastann pozisyonlamas, kemik mineral younluu deerlendirmesinde nemlidir. Doru pozisyonlama zerine teknisyenin rol nemli kabul edilirken, hastaya ait zelliklerin bu pozisyonlamaya etkisi yeterince aklanmamaktadr. Bu aratrmadaki amacmz; postmenopozal kadnlarn ya, boy, kilo ve vcut kitle indeksi gibi zelliklerinin pozisyonlama hatalarna etkileri olup olmadn aratrmaktr

Skeletal dysplasia is a complex and rare disease group that presents with clinical and radiological findings that differ from classical metabolic bone diseases in which bone and cartilage tissue are affected together. Spondyloepiphyseal dysplasia conjenita with involvement of the spine and long bone epiphyses is seen with short stature and short body from birth. Although bone deformities such as shortness of neck and vertebrae, kyphosis, scoliosis, pectus carinatum, genu varum or valgum are frequent, association with osteopenia/osteoporosis has been rarely reported. Although spondyloepiphyseal dysplasia tarda and osteopenia are coexisting in the literature, there is no evidence of the association of spondyloepiphyseal dysplasia tarda and conjunctiva with osteoporosis. In our case report, we presented a patient who was applied to our center with short stature, diagnosed with osteoporosis and spondyloepiphyseal dysplasia congenita by detecting femur head aplasia in radiological imaging.

Objective: The aim of this study is to determine the demographic and clinical characteristics of patients who underwent kyphoplasty due to osteoporotic fractures. Materials and Methods: This retrospective study included 55 patients who underwent kyphoplasty due to osteoporotic fracture between the years 2011 and 2014. The patients divided into two groups according to their ages (under/over 65 years), and divided into three groups according to fracture regions (T10 and above; between T11-L1; L2 and under). Thus the age and gender distributions of the patients were made. Resting pain scores of all patients were determined by using visual analog scale (VAS) and daily life activities by Oswetry Disability Index (ODI) before and in the first month of treatment. Results: Seventeen of the all patients were male (30.9%) and 38 were female (69.1%), with a mean age of 69.9±8.7 years (between 50-88 ages). 90% of the patients older than 65 years had fracture in T11 and below. In 45.5% of all patients, the fracture was in the T11-L1 (thoracolomber junction) region. Resting VAS and ODI scores significantly improved from 8.7±1.5 to 2.1±1.2 and 44.7±7.2 to 15.4±3.5 respectively in the first month after kyphoplasty (p<0.05). Kyphoplasty material extravasated to the disc space in 7 (12.7%) patients and in 4 (7.3%) patients to cerebrospinal fluid. Conclusion: Osteoporotic fractures affect patients over 65 years of age and are frequently occur in the thoracolumbar junction and lower vertebras. Kyphoplasty is a minimally invasive treatment option to relieve pain and to improve functional status.

Objective: In this study, it was aimed to evaluate the relationship between vitamin D level and pain severity, localization and duration in patients with non-specific musculoskeletal pain. Materials and Methods: Patients who applied to physical medicine and rehabilitation outpatient clinics due to non-specific muscle pain in 19 in Turkey were retrospectively screened. Three thousand four hundred fourpatients were included in the study, whose pain level was determined by visual analog scale (VAS) and the painful region, duration of pain and vitamin D level were reached. D group was found to be D deficient (group 1) when 25 (OH) D level was 20 ng/mL or less and group D 2 (vitamin D deficiency) was higher than 30 ng/mL (group 3). The groups were compared in terms of pain duration, localization and severity. In addition, the correlations of pain localization, severity and duration with vitamin D levels were examined.\nResults: D vitamin deficiency was detected in 2202 (70.9%) of 3 thousand four hundred and four registered patients, and it was found that vitamin D deficiency in 516 (16.6%) and normal vitamin D in 386 (12.4%). The groups were similar in terms of age, body mass index, income level, duration of complaint, education level, family type and working status (p&gt;0.05). There was no statistically significant difference between groups in terms of VAS, pain localization and duration scores (p&gt;0.05). Conclusion: Our study shows that vitamin D deficiency in patients with nonspecific musculoskeletal pain is not associated with the severity and duration of pain. Amaç: Bu çalışma ile özgül olmaya kas iskelet sistemi ağrısı olan hastalarda; vitamin D düzeyi ile ağrı şiddeti, lokalizasyonu ve süresi arasındaki ilişkinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Türkiye genelinde 19 merkezde özgül olmayan kas ağrısı nedeniyle fiziksel tıp ve rehabilitasyon polikliniklerine başvuran hastalar retrospektif olarak tarandı. Taranan hastalar arasında ağrı düzeyi visüel analog skala (VAS) ile belirlenmiş olan ve ağrılı bölge, ağrı süresi ve vitamin D düzeyi kayıtlarına ulaşılabilen 3104 hasta çalışmaya alındı. 25(OH)D düzeyi 20 ng/mL’den düşük ise D vitamini eksikliği (grup 1), 21 ile 29 ng/mL arasında ise D vitamini yetersizliği olan grup (grup 2) ve 30 ng/mL’den yüksek ise normal grup (grup 3) olarak kabul edildi. Gruplar ağrı süresi, lokalizasyonu ve şiddeti açısından karşılaştırıldı. Ayrıca D vitamini düzeyleri ile ağrı lokalizasyonu, şiddeti ve süresinin korelasyonları incelendi. Bulgular: Üç bin yüz dört kayıtlı hastanın 2202’sinde (%70,9) D vitamini eksikliği saptanırken, 516’sında (%16,6) D vitamini yetersizliği ve 386’sında (%12,4) normal sınırlarda D vitamini olduğu tespit edildi. Gruplar; yaş, vücut kitle indeksi, gelir düzeyi, şikayet süresi, eğitim düzeyi, aile tipi ve çalışma durumu yönünden benzer olarak saptandı (p&gt;0,05). VAS, ağrı lokalizasyonu ve süresi skorları yönünden gruplar arasında istatistiksel olarak anlamlı fark bulunmadı (p&gt;0,05). Sonuç: Çalışmamız özgün olmayan kas iskelet ağrısı olan hastalarda D vitamini eksikliğinin ağrının şiddeti ve süresi ile ilişkili olmadığını göstermektedir.

Osteoporosis in men is an important public health problem, and its prevalence is increasing as the population ages. Although it is traditionally considered as a women's health issue, osteoporosis-related mortality and morbidity rates are higher in men. Although the lifetime risk of the hip fracture is lower in men than women, men are twice as likely to die after a hip fracture. All men diagnosed with osteoporosis should be evaluated for secondary causes of bone loss, such as hypogonadism, the use of corticosteroid, smoking, excessive alcohol consumption, low calcium intake, vitamin D deficiency and hypothyroidism. Here, we aimed to present a male patient in whom osteoporotic a vertebral fracture was detected and who was diagnosed with hyperthyroidism.

A 44-year-old male patient with Behcet’s disease presented to our clinic with progressively worsening right knee pain and suprapatellar swelling. The knee pain started about a month previously and increased over time. The characteristic of the pain was mechanical. He did not feel pain while sleeping. Previously, he had received analgesic medications but there had been no significant improvement. There was no pain in any other joint, and there was no history of disease or trauma and arthritis attack associated with the knee. The patient had a history of Behcet’s disease for five years and patient was using colchicine 3x1 pozology a day. On physical examination there was no arthritis findings. Patella shock test was negative. The patient was seen to have visibly swollen suprapatellar area. On palpation the swelling was hard, non-mobile, well defined, and measured 2x1 cm. Radiography of the knee indicated multiple soft tissue calcifications outside the joint capsule of the right knee. Knee magnetic resonance imaging revealed expanded sinovium that contained osteochondromas, which were hypointense all sequences (Figure 1). The patient’s blood tests were normal. Arthroscopic debridement were performed with symptomatic right knee joint. Pathology results were evaluated as synovial chondromatosis (SC). SC is a rare arthropathy of unknown etiology. The disease is generally monoarticular, usually occurs unilaterally in the large joints like the knee, hip, and elbow (1). Primary or idiopathic form may occur in an otherwise normal joint, but secondary SOC may occur due to trauma or degenerative diseases. On the other hand, it may occur in the setting of preexistent osteoarthritis, rheumatoid arthritis, osteonecrosis, osteochondritis dissecans, neuropathic osteoarthropathy, tuberculosis, or osteochondral fractures (2,3). To the best of our knowledge, the suprapatellar SOC of the knee in a Behcet disease is rare, and this encouraged us to report this case. Secondary SC should be included in the differential diagnosis of Behcet disease’s joint pain.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect almost any organ system. Its presentation and course are highly variable. The classic presentation of SLE in a woman of childbearing age is fever, arthritis, and malar rash triad. However, patients may present rare types of manifestations such as idiopathic thrombocytopenic purpura.

Objective: To evaluate the concomitant systemic diseases with postmenopausal osteoporosis and to investigate the points to be considered in treatment approach of patients with osteoporosis. Materials and Methods: The study included 110 female patients admitted to our clinic and followed up after postmenopausal osteoporosis diagnosis. Besides the demographic data; the concomitant diseases of the patients such as hypertension, hypo-hyperthyroidism, diabetes mellitus, Alzheimer’s disease, malignancy, osteoarthritis, gastrointestinal system diseases, chronic obstructive pulmonary disease (COPD)- asthma and depression were also recorded. Results: The mean age of the patients included in our study was 65.9±9.8 years. When the concomitant systemic diseases were examined; 40 patients had hypertension, 32 patients had osteoarthritis, 24 patients had gastrointestinal tract problems, 22 patients had thyroid disease, 21 patients had depression, 15 patients had hyperlipidemia, 12 patients had diabetes mellitus, 10 patients had COPD - asthma, 7 patients had cardiac diseases, 5 patients had malignancy and 2 patients had Alzheimer disease. Conclusion: Osteoporosis is a common disease in the geriatric population. As a chronic disease with an increasing incidence with aging; it can cause many health problems, prevalently pathological bone fractures, in our country and all over the world. Constitutively, prophylaxis of osteoporosis should be the first step. Because systemic diseases with increasing incidence with aging may affect the severity of osteoporosis and impair the treatment; it is important for both clinicians and the society to have sufficient information about osteoporosis.

Hallux sesamoids are composed of two sesamoid bones within the flexor hallucis brevis tendon inferior to the metatarsophalangeal joint of the pollex.The one that is present in medial part is called the tibial sesamoid and the lateral one is called as fibular sesamoid.The tibial sesamoid is more frequently affected by trauma, as it is centrally located to inferior of the first metatarsal bone.A 41-year-old female patient was admitted to the clinic with the complaints of pain in the right sole and around the pollex persisted for two weeks.The patient explained that the pain developed after a long walk wearing high heels.She was admitted to the center with these complaints.She was admitted to a center with these complaints, diagnosed with hallux valgus and was recommended to receive medical therapy and wear a hallux valgus relaxation brace.Upon her physical examination, there was tenderness in the first metatarsophalangeal joint of the right pollex.The joint movements were markedly painful especially during extension.Hallux valgus deformity was detected.A linear line causing separation in the tibial sesamoid bone of the right pollex was detected in the roentgenogram of the right foot.Magnetic resonance imaging was performed with the initial diagnoses of fracture and bipartite tibial sesamoid and a hypointense fracture line consistent with fracture in the tibial sesamoid bone was detected in T1 and T2 weighted images.The patient was consulted with the Orthopedics and Traumatology Department.Metatarsal pad together with foot orthosis and no weight bearing for four weeks were recommended.It was observed that the patient's complaints regressed after four weeks.Although a trauma was not present, the possibility of a tibial sesamoid fracture should be considered in patients who were admitted with the complaints of pollex pain and the patient should be evaluated in this respect.