Immediate effects of Kinesio taping in carpal tunnel syndrome: A randomized controlled double-blind ultrasonographic study.

BACKGROUND: The effects of Kinesio taping (KT) in carpal tunnel syndrome are controversial. PURPOSE: This study aimed to examine whether KT has any effect on the skin, subcutaneous tissue, and median nerve measurements and to compare the effects of two different KT applications. STUDY DESIGN: This is a prospective, double-blinded, randomized trial. This study was prospectively registered on the clinicaltrials.gov (NCT05475197). A total of 34 wrists (21 patients) who were clinically and electrophysiologically diagnosed with mild/moderate carpal tunnel syndrome were randomly divided into two KT intervention groups (group 1: neural technique and area correction technique and group 2: area correction technique). METHODS: At baseline and immediately after the removal of KT (48 hours), pain was assessed with visual analog scale, hand grip strength with a hand-held dynamometer, and pinch strength using a pinch meter. Likewise, using ultrasound, skin and subcutaneous tissue thicknesses, median nerve cross-sectional area and flattening ratio, as well as median nerve depth were measured at the carpal tunnel inlet and outlet levels. RESULTS: While there was significant improvement in the pain scores (compared to the baseline) immediately after the KT in both groups (group 1: p = 0.03, ηp2 = 0.44; group 2: p < 0.001, ηp2 = 0.71), there was no difference in between (p = 0.07, ηp2 = 0.10). Grip strength significantly increased only in group 2 (p = 0.01, ηp2 = 0.35). None of the sonographic measurements displayed significant difference either within or between groups at baseline and after KT (all p > 0.05). CONCLUSIONS: While pain scores improved after KT, they were not coupled with any morphologic changes assessed by ultrasound.

Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis.

OBJECTIVES: To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). METHODS: A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. RESULTS: Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. CONCLUSIONS: Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.

Relation of the Fas and FasL gene polymorphisms with susceptibility to and severity of rheumatoid arthritis.

To investigate associations of the Fas and FasL genes polymorphisms with rheumatoid arthritis (RA). One hundred patients with RA and age-, sex- and ethnically matched 101 controls were included. Four polymorphisms of Fas (-670 A>G rs1800682, -1377 G>A rs2234767) and FasL (IVS2nt-124 A>G rs5030772, -844 T>C rs763110) genes were typed from genomic DNA. Genotype distributions and allelic frequencies were compared between patients and control subjects. After the history and clinical examination of patients with RA, in terms of pain, fatigue and general health status were evaluated by visual analogue scale. Thereafter, erythrocyte sedimentation rate, C-reactive protein, blood count and rheumatoid factor levels were measured. The Disease Activity Score-28, Health Assessment Questionnaire and modified Sharp score were used to evaluate the disease activity, functional disability and radiological damage, and their relationships with the Fas and FasL gene polymorphisms were investigated. In patients with RA, CT and TT genotypes of FasL-844, polymorphism were twofold and 4.8-fold higher, and AA genotype of FasL IVS2nt-124 polymorphism was 3.4-fold higher than the control group (respectively, p = 0.05, p = 0.002, p = 0.039). T allele of FasL-844 polymorphism was more frequent in patients than controls (respectively, 52.5 vs. 41.4 %, p = 0.027). Any association was not detected between Fas (-670 A>G, -1377 G>A) and FasL (-844 T>C, IVS2nt-124 A>G) gene polymorphisms with the disease activity scores, functional disability and radiological damage. However, the Fas-670 A>G polymorphism was associated with drug therapy (p = 0.049). The distribution of GG genotype was higher compared to GA or AA genotypes in patients using triple disease-modifying antirheumatic drug therapy (71.4, 14.3 and 14.3 %, respectively). These findings suggest that the -844 T>C and IVS2nt-124 A>G polymorphisms in the FasL gene related with apoptosis may increase genetic susceptibility to RA in a Turkish population. In addition, the Fas-670 A>G gene polymorphism may be associated with disease progression. There is a need for further studies to clarify the genetic role of apoptosis in RA.

Apoptosis-related Fas and FasL gene polymorphisms' associations with knee osteoarthritis.

To investigate the associations between Fas and FasL gene polymorphisms and susceptibility to knee osteoarthritis. Genomic DNA was obtained from 146 patients with knee osteoarthritis and 102 healthy controls. Genotype distributions and allelic frequencies of four polymorphisms of Fas (-670 G>A rs1800682, -1377 G>A rs2234767) and FasL (IVS2nt-124 A>G rs5030772, -844 T>C rs763110) genes were compared between the groups. Thereafter, this association was investigated between patients and controls of the same sex. There were significant differences between patients with knee osteoarthritis and controls regarding the genotype distributions and allelic frequencies of Fas-1377 G>A polymorphism (P = 0.0001 and P = 0.005, respectively). The Fas-1377 GG genotype and G allele were significantly more frequent in patients with knee osteoarthritis than in controls. Genotype distributions and allelic frequencies of Fas-670 G>A, FasL-844 T>C, and FasL IVS2nt-124 A>G polymorphisms did not differ between the groups (P > 0.05). However, there were no significant differences between patients and controls of the same sex (P > 0.05). These findings suggest that the Fas-1377 G>A polymorphism in the Fas gene related with apoptosis may contribute to susceptibility to knee osteoarthritis in the Turkish population. There is a need for further studies to evaluate the role of apoptosis in large cohorts.

Association of (-1,607) 1G/2G polymorphism of matrix metalloproteinase-1 gene with knee osteoarthritis in the Turkish population (knee osteoarthritis and MMPs gene polymorphisms).

The aim of this study was to investigate whether functional polymorphisms in the promoter of matrix metalloproteinase-1 (MMP-1), MMP-2 and MMP-9 genes were associated with susceptibility to knee osteoarthritis in the Turkish population. The MMP-1 -1,607 1G/2G (rs1799750), MMP-2 -1,306 C/T (rs243865), and MMP-9 -1,562 C/T (rs3918242) polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism assay in 157 patients diagnosed with knee osteoarthritis based on the criteria of American College of Rheumatology and in 84 controls in Mersin, Turkey. Genotype distributions and allele frequencies of MMP-1, MMP-2, and MMP-9 gene polymorphisms were compared between the patients and controls. There were significant differences between the groups regarding the genotype distribution of MMP-1 polymorphism (P = 0.001). The frequencies of 1G/1G and 1G/2G genotypes were significantly higher in the knee osteoarthritis than in the controls (P = 0.002, and P = 0.006, respectively). In addition, 1G allele frequency of MMP-1 gene was higher in the patients than in the control group (P = 0.0001). The genotype distributions and allele frequencies of MMP-2 and MMP-9 gene polymorphisms did not differ between the osteoarthritis and the control groups (P > 0.05). These findings suggest that the -1,607 1G/2G polymorphism in the MMP-1 gene may contribute to susceptibility to knee osteoarthritis in the Turkish population.

Effect of coexisting foot deformity on disability in women with knee osteoarthritis.

BACKGROUND: Knee osteoarthritis, a common musculoskeletal disorder, can cause considerable pain and disability. This study investigates the effect of certain foot deformities on the functional status of women with knee osteoarthritis. METHODS: The common foot deformities pes planus and hallux valgus were evaluated in 115 women with knee osteoarthritis and Kellgren-Lawrence grade 2 and 3 osteoarthritis. Anteroposterior and lateral foot-ankle standard radiographs were obtained bilaterally. A lateral talometatarsal angle greater than 4 degrees was defined as pes planus. A hallux valgus angle greater than 21 degrees was defined as hallux valgus. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to objectively assess functional impairment. Knee pain intensity was measured with a visual analog scale. RESULTS: Fifty-nine patients had bilateral pes planus, hallux valgus, or both. The mean visual analog scale value was higher for the deformity group, but the difference was not statistically significant. There was a significant difference in WOMAC scores between the group with foot deformities versus the group without (P = .000). Visual analog scale scores were positively correlated with WOMAC scores (r = 0.499, P = .000). Also, there was a significant correlation between WOMAC scores and lateral talometatarsal angle (r = 0.266, P = .004) and hallux valgus angle (r = 0.362, P = .000) values. CONCLUSIONS: There is a significant correlation between indicators of pain and disability (visual analog scale and WOMAC scores). Also, the presence of foot deformities increased disability levels in women with knee osteoarthritis.

Lack of association polymorphisms of the IL1RN, IL1A, and IL1B genes with knee osteoarthritis in Turkish patients.

PURPOSE: To examine whether polymorphisms of the interleukin 1 receptor antagonist (IL1RN), interleukin 1 alpha (IL1A) and interleukin 1 beta (IL1B) genes are markers of genetic susceptibility to knee osteoarthritis in Turkish patients. METHODS: One hundred and seven patients with knee osteoarthritis and 67 controls were studied. Three polymorphisms of IL1A, IL1B, and IL1RN genes were typed from genomic DNA. Allelic frequencies were compared between patients and control subjects. RESULTS: No significant differences were observed in genotype and allele frequencies of the IL1RN VNTR, IL1A+4845, IL1B+3953 genes polymorphisms between patients and controls. Furthermore, we did not detect any association genotypes of the polymorphisms with the clinical, radiological, and laboratory profiles of patients. CONCLUSIONS: The present study suggest that the IL1RN VNTR, IL1A+4845, IL1B+3953 genes polymorphisms are not genetic markers of susceptibility to knee osteoarthritis in Turkish patients, and are unrelated to the clinical, radiological, and laboratory characteristics of knee osteoarthritis.

Serum RDW and MPV in Ankylosing Spondylitis: Can they show the disease activity?

OBJECTIVE: To determine RDW and MPV levels in Ankylosing Spondylitis (AS) and to investigate their relations with disease activity. MATERIALS AND METHODS: 133 patients with AS (male: 80, female: 53) and age-sex matched 133 controls (male: 79, female: 54) were enrolled. Demographic data, disease activity scores, Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) levels were recorded. RESULTS: The mean ages of patients and controls were 41.9±11.2 and 39.7±14.2 years respectively (p = 0.16). RDW (14.5±1.6% and 13.2±0.8%, p < 0.0001 respectively) and MPV (10.1±0.8fl and 9.9±0.7fl, p = 0.03, respectively) were significantly higher in patients with AS than in controls. There was a significant difference in RDW between patients with active AS (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >4) and those with inactive AS (BASDI <4) patients (14.84±1.79fl, 14.24±1.37fl, p = 0.035 respectively). RDW was positively correlated with BASDAI (r = 0.33, P < 0.0001), ESR (r = 0.45, P < 0.0001) and CRP (r = 0.42, P < 0.0001) and PLT levels (r = 0.24, P = 0.004). While MPV was not correlated with BASDAI, it was negatively correlated with ESR (r = -0.19, P = 0.03), CPR (r = -0.26, P = 0.004) and PLT levels (r = -0.39, P = <0.0001). CONCLUSIONS: RDW and MPV were significantly higher in the patients with AS than in the controls. While RDW was correlated with BASDAI and APRs, MPV was only correlated with APRs.

Soft tissue composition, axial bone mineral density, and grip strength in postmenopausal Turkish women with early rheumatoid arthritis: Is lean body mass a predictor of bone mineral density in rheumatoid arthritis?

OBJECTIVE: To study bone mineral density and body composition in patients with early rheumatoid arthritis to determine the relationship of lean mass, fat mass and hand grip strength to bone mineral density. METHODS: Fifty-one female patients who fulfilled the American College of Rheumatology (ACR) for RA were recruited. Fifty-one (51) female RA patients, age matched female control subjects and 53 osteoporotic patients (WHO criteria) were included in the study. All subjects were at postmenopausal period. Early RA is defined as the disease duration <10 years. Whole body composition and BMD were estimated by DEXA (Norland XR-46). Hand grip strength was measured by JAMAR hand dynamometer. Body mass index (BMI) and anthropometric measures (skinfold thickness and waist-hip ratio) were also assessed. RESULTS: The mean age of patients and controls was 55.4 +/- 9.5, 56.9 +/- 7.4, and 55.2 +/- 7.6, respectively. There was no statistically significant difference in age, BMI, and years since menopause between RA patients, OP patients, and controls (p < 0.05). Bone mineral density of lumbar and femoral neck regions, total bone mineral density, and bone mineral content in RA patients were significantly lower than in controls but not in osteoporotic patients. Lean body mass was also significantly lower in RA patients than controls but not in osteoporotic patients. However, hand grip strength was significantly lower in RA patients than in osteoporotic patients and controls (p < 0.05). Total lean mass was correlated with body mass index, waist-hip ratio, femoral neck BMD, and total bone mineral content, total BMD in RA patients (p < 0.05). Grip strength was correlated with duration of disease (RA) and age negatively, and also correlated with total BMD in RA patients. CONCLUSION: These results indicate that lean mass was associated with BMD. To preserve BMD, maintaining or increasing lean mass would appear to be an appropriate strategy for avoiding hip fracture and its complications.

Can mean platelet volume and red blood cell distribution width show disease activity in rheumatoid arthritis?

AIM: To evaluate the relationship between mean platelet volume (MPV) and red cell distribution width (RDW), and disease activity in rheumatoid arthritis (RA). PATIENTS & METHODS: Hundred RA and 100 controls were included. RESULTS: MPV and RDW were higher in RA (p < 0.0001). The cut-off levels of RDW and MPV were 14.8 and 10.4. Patients with RDW >14.8 had higher Disease Activity Score 28 (DAS28; p = 0.002) and pain score (p = 0.0007). RDW was positively correlated with DAS28 and pain. But, DAS28 and pain were not different between patients with MPV >10.4 and <10.4. CONCLUSION: MPV and RDW were significantly higher in RA. RDW and MPV were similar to erythrocyte sedimentation rate and C-reactive protein to indicate inflammatory activity. RDW was correlated with pain and DAS28, but MPV was not associated with them.

Bone mineral density in premenopausal women with major depression.

AIM: To investigate the relationship between the major depression and bone mineral density (BMD) in premenopausal women. MATERIAL AND METHODS: We compared BMD, plasma cortisol level, osteocalcin and C-telopeptide levels of 35 premenopausal women with major depression with those of 30 healthy women who were matched for age and body mass index. Major depression was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (fourth edition) criteria. Nineteen patients had mild and 16 patients had moderate severity of major depression as measured by Hamilton rating scale for depression. RESULTS: Women with any risk factor for osteoporosis were excluded from the study. All women underwent BMD measurement by DEXA at lumbar (L2-4) and femoral neck region. After an overnight fasting, plasma cortisol levels were measured at 08:00 h by using competitive immunoassay method. Osteocalcin and C-telopeptide were used for the evaluation of bone turnover. There were no significant differences in BMD, plasma cortisol level, osteocalcin and C-telopeptide levels between the patients and the control groups. There was also no correlation between the plasma cortisol level, the duration and the severity of disease, antidepressant drug use and BMD. CONCLUSION: Major depression had no significant effect on BMD and bone turnover markers in our patient group of mild to moderate severity of the disorder.

Sleep quality in patients with chronic low back pain: a cross-sectional study assesing its relations with pain, functional status and quality of life.

OBJECTIVE: The aim of this study was to investigate sleep quality in patients with chronic low back pain (CLBP) and its relationship with pain, functional status, and health-related quality of life (HRQOL). METHODS: Two hundred patients with CLBP aged 20-78 years (mean: 50.2 years) and 200 sex- and age-matched pain-free healthy controls (HCs) aged 21-73 years (mean: 49.7 years) were included in this study. After lumbar region examination, in patients, pain was evaluated with the Short Form-McGill Pain Questionnaire (SF-MPQ), functional capacity with the Functional Rating Index (FRI), and health-related quality of life with the Short Form-36 (SF-36). The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality of both groups.The sleep quality was compared between the patients and HCs. In patients with CLBP, its relations with pain, functional status and HRQOL were also investigated. RESULTS: The patients had significantly higher total scores (8.1 ± 4.3, 4.6 ± 3.4, P< 0.001, respectively) and subscale scores (P< 0.001) for PSQI compared to HCs. The groups were only similar in use of sleeping medication (P> 0.05) Among the patients, sleep quality was worse in women, in the patients with complaints more than 11 years, in the patients with low back and two leg pain (P< 0.05). Mean scores of the FRI, SF-MPQ, and visual analog scale in the patients were 8.5 ± 3.0, 16.7 ± 8.0, 6.9 ± 1.2, respectively. The PSQI total scores of patients were positively related with both SF-MPQ and FRI scores (P< 0.001). Also, there were negative relationships between the physical component summary score of the SF-36 and all subscale scores of the PSQI, without sleep duration of PSQI (P< 0.001). CONCLUSION: The sleep quality of patients with CLBP was worse compared to HCs, and there were positive relations between the sleep quality with pain and functional status. Also, the poor sleep quality had negative effect on the physical component of quality of life.

Study of axial bone mineral density in postmenopausal women with diffuse idiopathic skeletal hyperostosis related to type 2 diabetes mellitus.

OBJECTIVE: The association of bone mineral density (BMD) with diffuse idiopathic skeletal hyperostosis (DISH) related to diabetes mellitus was studied. METHODS: We measured BMD and elevated known determinants of BMD (bone markers) in 35 patients with DISH-related type 2 diabetes mellitus, 47 type 2 female diabetics, and 52 female controls with no systemic disease and no drug administration. All subjects were matched for age and body mass index (BMI). All subjects were in the postmenopausal period. RESULTS: Among subjects, BMD values were significantly higher in DISH patients than in diabetics and controls (p < 0.05). In addition, the duration of diabetes mellitus was longer in DISH patients and significantly correlated with total hip BMD in DISH patients (p < 0.05). CONCLUSIONS: Patients with DISH have higher BMD, and increased BMD probably results from hyperostosis of the axial skeleton, which may cause decreased fracture risk.

Pulmonary muscle strength, pulmonary function tests, and dyspnea in women with major depression.

OBJECTIVE: To evaluate the subjective sensation of dyspnea compared with pulmonary function tests, pulmonary muscle strength, and chest expansion in depressed women and control subjects free of cardiorespiratory disease. METHODS: Thirty female patients with major depression (MD) and 30 age-matched female control subjects were included in the study. All subjects were assessed by pulmonary function tests (spirometry) and pulmonary muscle strength measurement (maximum inspiratory and expiratory pressures [MIP and MEP]) by mouth pressure meter (MPM). Chest expansion was measured, and body mass index (kg/m(2)) (BMI) was calculated. The Health Assessment Questionnaire (HAQ) was used to evaluate the activities of daily living, and a dyspnea score was used to determine dyspnea severity. RESULTS: There were no significant differences between groups regarding pulmonary function tests, pulmonary muscle strength, and chest expansion. HAQ scores were significantly lower in women, and dyspnea was higher with MD compared with controls (p < 0.05). BMI was also lower in depressed patients (p < 0.05). CONCLUSIONS: The subjective sensation of dyspnea is increased in women with MD in the presence of normal lung function and is associated with the level of anxiety rather than that of depression.

The effect of hand osteoarthritis on grip and pinch strength and hand function in postmenopausal women.

The aim of the study was to investigate the effect of osteoarthritis on hand function in postmenopausal women. One hundred patients with hand OA and 70 healthy volunteers as controls were evaluated. Grip and pinch strength measurements and Dreiser's functional index were used for hand function. Pain was assessed by a visual analog scale, and tenderness was assessed by palpation and scored, depending on the severity of tenderness, as 0, 1 or 2. Heberden's and Bouchard's nodules and joint involvement were also recorded. The number of patients with only distal interphalangeal joint involvement was 50 (50%), those with distal interphalangeal joint plus proximal interphalangeal joint involvement was 49 (49%), and those with carpometacarpal joint involvement numbered 18 (18%). The incidence of Heberden's and Bouchard's nodules was 85% and 36%, respectively. Eighty-six (86%) patients were suffering from pain and 57 were found to have tenderness. Grip and pinch strength was significantly lower (p<0.05) and Dreiser's functional index score was significantly higher (p<0.001) in the study group (particularly in grade 4 OA). Grip strength was lower in hand OA patients with distal interphalangeal joint plus proximal interphalangeal joint involvement than in those with only distal interphalangeal joint and carpometacarpal joint involvement. Pinch strength was also lower in patients with distal interphalangeal joint plus proximal interphalangeal joint plus carpometacarpal joint involvement. The patients with Heberden's and Bouchard's nodules had lower grip and pinch strength than controls. Also, pain and tenderness had significant (p<0.05) effects on hand function. Dreiser's total score ranged from 0 to 10 in 80 (80%) patients and from 11 to 20 in 20 patients. In conclusion, hand osteoarthritis contributes to hand dysfunction, mainly related to the severity of osteoarthritis, pain, joint involvement and the presence of nodules.

Respiratory muscle strength but not BASFI score relates to diminished chest expansion in ankylosing spondylitis.

Pulmonary function is altered in ankylosing spondylitis (AS) owing mainly to the restriction of chest wall involvement (limited chest expansion). The objective of this study was to investigate the relationship between chest expansion, respiratory muscle strength (MIP, MEP) maximum voluntary ventilation (MVV), and BASFI score in patients with AS. Twenty-three male patients with definite AS and 21 age-matched healthy male controls were recruited for the study. Patients with AS were assessed for functional status by BASFI. Measurement of chest expansion and lumbar spinal flexion (modified Schober) method was performed in all subjects. Pulmonary function tests were performed by spirometry. Respiratory muscle strength was evaluated by a mouth-pressure meter (MPM). Body mass index (kg/m(2)) was recorded in all individuals. Chest expansion and modified Schober measurement were significantly lower in AS patients (p<0.05). Pulmonary function tests revealed restrictive lung disease. The mean BASFI score suggested good functional capacity in the AS group. The respiratory muscle strength and MVV were also lower in AS (p<0.05). The chest expansion was correlated with MIP and MEP values (r=0.491; p=0.02, r=0.436; p=0.05). Chest expansion was also correlated negatively with disease duration (r=-0.502; p=0.03). In addition, there was no correlation between chest expansion and BASFI score (r=-0.076; p=0.773). This study demonstrates that functional status (BASFI) is not influenced by the limitation of chest wall movement. It may be as a result of the maintenance of moderate physical activity during active life in patients with AS.

Bronchiolitis obliterans organizing pneumonia associated with sulfasalazine in a patient with rheumatoid arthritis.

Pulmonary toxicity and blood dyscrasias are rare side effects of sulfasalazine. Pulmonary pathology is variable, the most common being eosinophilic pneumonia with peripheral eosinophilia, and interstitial inflammation with or without fibrosis. We here present the case of a 68-year-old female patient treated for 6 months with sulfasalazine for rheumatoid arthritis. On laboratory examination, eosinophil count was 97 x 10(3) mm(3). Thorocoscopic biopsy was performed. Histopathologic diagnosis was bronchiolitis obliterans organizing pneumonia (BOOP). This is the first case in the literature to present with sulfasalazine-induced BOOP in a patient with seronegative RA.

Is chest expansion a determinant of pulmonary muscle strength in primary fibromyalgia?

OBJECTIVE: To examine the possible relationship between chest expansion and pulmonary muscle strength in patients with primary fibromyalgia (PFM). METHODS: Forty-one consecutive women with PFM were compared with age and body mass index matched 40 healthy women concerning pulmonary function tests, chest expansion, and maximum respiratory pressures indicating pulmonary muscle strength, and endurance (MVV). Pain was scored according to a visual analog scale (VAS). Chest pain was scored on a 10 point scale. RESULTS: There was no significant difference between the two groups regarding chest expansion (P > 0.05). Maximum inspiratory and expiratory pressures (MIP, MEP) were lower in fibromyalgia patients than controls (P < 0.05). However, chest expansion and dyspnea score were insignificant between groups (P > 0.05). CONCLUSION: Reduced maximum respiratory pressures (MIP, MEP) may result from isometric type pulmonary muscle dysfunction as a result of low physical performance in fibromyalgia patients, despite insignificant finding of chest expansion and dyspnea score according to controls.

The anterior center edge angle: a study of 102 volunteers.

OBJECTIVES: To measure the anterior center edge (VCE) angle that reflects anterior coverage of the femoral head. PATIENTS AND METHODS: False profile views of both hips of 102 volunteers, 23 male and 79 female, were taken between October 2000 and October 2001. Radiographs with evidence of degenerative hip disease and those with poor image quality were excluded from the study. This left 181 radiographs. RESULTS: An orthopedic surgeon and a radiologist used a standard protractor to examine each of the 181 radiographs twice, at an interval of 24 h. The mean VCE angle was 49.27 +/- 7.77 degrees (range, 24.75-68.75), a value different from those found in previous studies. No significant intraobserver or interobserver differences were found. CONCLUSIONS: Our findings may contribute to the determination of a new parameter for evaluating anterior femoral head covering. In patients with acetabular dysplasia and deficient anterior coverage, this parameter may prove useful for selecting patients for surgery, planning the procedure, and evaluating postoperative results.

Bone mineral density and grip strength in postmenopausal Turkish women with osteoporosis: site specific or systemic?

OBJECTIVE: To assess the relationship of grip strength to site-specific bone mineral density of the metacarpal bone and also axial bone mineral density. The bone mineral density of the lumbar spine, femoral neck and the nondominant hand were measured by DEXA. SUBJECTS: A total of 187 postmenopausal women were included in the study. Of the patients, 102 were osteoporotic, and 85 were not osteoporotic and served as control subjects. METHODS: Grip strength of the nondominant hand was measured by hand-held dynamometer. Skinfold thickness of the nondominant hand was measured by a caliper (Holstain). Biochemical markers of bone turnover and other osteoporosis-related variables were also measured. RESULTS: There was a statistically significant difference between groups regarding bone mineral density of the lumbar, femoral (neck) and hand regions and the grip strength (P < .05). Hand bone mineral density (BMD) was found to be correlated with bone mineral density of the lumbar and femoral (neck) regions in osteoporotic patients. Grip strength was correlated positively with the BMD of the nondominant hand. Grip strength was correlated negatively with age and years since menopause. Grip strength was also correlated positively with femoral neck BMD. CONCLUSION: The study provides support for a site-specific and also systemic relationship between muscle and bone. Grip strength is also a predictor of hand bone mineral density.