RESUMO
Gout is a chronic rheumatic disease resulting from accumulation of monosodium urate crystals in tissues. The most important risk factor for the disease is hyperuricaemia. Precipitation of uric acid in the joint in the form of monosodium urate crystals is the main factor responsible for triggering attacks of arthritis. Tophi occur as a result of urate crystals that precipitate into joints and surrounding tissues. Tophi can erode the bone where they are located and cause compression in soft tissue due to a mass effect. The following case report describes a case of cubital tunnel syndrome developed in association with tophaceous compression and resolved with surgical decompression in a patient with chronic gouty arthritis.
Assuntos
Artrite Gotosa , Síndrome do Túnel Ulnar , Anti-Inflamatórios/uso terapêutico , Artrite Gotosa/complicações , Artrite Gotosa/diagnóstico , Artrite Gotosa/terapia , Síndrome do Túnel Ulnar/diagnóstico , Síndrome do Túnel Ulnar/etiologia , Síndrome do Túnel Ulnar/terapia , Descompressão Cirúrgica , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Ácido ÚricoRESUMO
OBJECTIVES: The objective of this study is to investigate whether patients with androgenetic alopecia were at risk in terms of urinary system stone disease. PATIENTS AND METHODS: Patients with no baldness (Hamilton-Norwood Scala [HNS] stage I) were categorized as Group I, those with hair loss in the frontal region (HNS stages II, III, IIIa, and IVa) as Group II, those with hair loss in the vertex region (HNS stage III-vertex, V) as Group III and those with hair loss in both vertex and frontal regions (HNS stages IV, Va, VI, and VII) as Group IV. Patients in all groups were compared in terms of presence of stone, and the presence of any association between alopecia and urolithiasis, with common etiological risk factors, was investigated. RESULTS: Three hundred and two male patients were included in the study. The presence of urolithiasis was detected in 28.9% of patients in Group I; 26.5% of Group II; 36.9% of Group III; and 44.4% of Group IV (p = 0.085). Among patients aged under 60, urinary stone disease was detected in 30.8% of patients in Group I; 26.4% of Group II; 41.2% of Group III; and 53.8% of Group IV (p = 0.001). In patients aged over 60, urolithiasis was detected in 12.5% of patients in Group I; 26.9% of Group II; 32.2% of Group III; and 37.8% of Group IV (p = 0.371). CONCLUSIONS: We determined a significant correlation between vertex pattern and total alopecia with urolithiasis in patients younger than 60 years old.
Assuntos
Alopecia/epidemiologia , Urolitíase/epidemiologia , Adulto , Fatores Etários , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologiaRESUMO
Subcapsular or perirenal hematoma is an unusual complication after semirigid ureteroscopy using pneumatic lithotripsy to treat ureteral stones. We present a patient who developed a large subcapsular and perirenal hematoma following ureteroscopy administered to a stone in the right ureter.
Assuntos
Hematoma/etiologia , Rim/lesões , Litotripsia/efeitos adversos , Cálculos Ureterais/terapia , Ureteroscopia/efeitos adversos , Diagnóstico Diferencial , Drenagem , Hematoma/diagnóstico por imagem , Hematoma/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: To investigate whether congenital renal vein anomalies are involved in the etiology of hematuria by analyzing abdominal multidetector computed tomography (MDCT) results. METHODS: Six hundred and eighty patients undergoing MDCT for various abdominal pathologies in whom possible causes of hematuria were excluded were retrospectively assessed in terms of left renal vein anomalies, such as circumaortic left renal vein (CLRV), retroaortic left renal vein (RLRV) and multiple renal vein (MRV). Patients with CLRV, RLRV or MRV and patients with normal left renal veins were compared in terms of the presence of hematuria. RESULTS: Left renal vein anomalies were detected in 100 patients (14.7%). RLRV, CLRV and MRV were identified in 5.4, 2.5 and 6.8% of patients, respectively. Hematuria was determined in 8.1% of patients with an RLRV anomaly and in 10.5% of patients with no RLRV anomaly (p=0.633). Hematuria was detected in 23.5% of patients with a CLRV anomaly and 10.1% of those without (p=0.074), and in 21.7% of patients with an MRV anomaly and 9.6% of those without (p=0.009). CONCLUSIONS: In addition to increasing risk of complication during retroperitoneal surgery, numeric congenital renal vein anomalies are also significant in terms of leading to clinical symptoms such as hematuria.
Assuntos
Hematúria/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Veias Renais/diagnóstico por imagem , Anormalidades Urogenitais/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hematúria/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Veias Renais/anormalidades , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Anormalidades Urogenitais/complicações , Adulto JovemRESUMO
Thyroid hemiagenesis is an infrequent congenital disorder which is rarely associated with hyperparathyroidism. We present a case of an adult woman who presented with hyperparathyroidism and ipsilateral thyroid hemiagenesis. Parathyroid adenoma was excised by minimal invasive parathyroidectomy.
Assuntos
Hiperparatireoidismo/etiologia , Glândula Tireoide/anormalidades , Adenoma/complicações , Adenoma/cirurgia , Adulto , Diagnóstico por Imagem , Feminino , Humanos , Hiperparatireoidismo/cirurgia , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/cirurgia , ParatireoidectomiaRESUMO
OBJECTIVE: To investigate early diagnostic effects of serum myelin basic protein (MBP) and ischemic modified albumin (IMA) levels in patients with ischemic stroke. METHODS: Fifty patients who presented to an emergency service with acute ischemic stroke between June 2013 to March 2014 were evaluated with the National Institute of Health Stroke Scale (NIHSS) and diffusion-weighted magnetic resonance imaging (MRI). Thirty four healthy cases were included as control group. All patients' serum IMA and MBP level were assessed. RESULTS: Mean IMA value was 0.52±0.25 cases with acute ischemic stroke and serum IMA levels were significantly higher than the control group (p<0.01). No statistical significance was observed between acute ischemic stroke group and control group related to the MBP serum levels (P>0.05). Statistically significant correlation was detected between the volumes of diffusion restriction on MRI and NIHSS score (P=0.002, r=0.43) and IMA (P=0.015, r=0.344) levels. CONCLUSIONS: We have found that serum IMA levels are elevated in acute ischemic stroke cases and these levels are correlated with the ischemic tissue volume. MBP levels do not increase in early period of stroke cases.
RESUMO
[Purpose] The aim this study was to assess the relation between bone mineral density (BMD) and mean platelet volume (MPV) in ankylosing spondylitis (AS) patients, and evaluate the diagnostic role of the diffusion-weighted magnetic resonance imaging (MRI). [Subjects and Methods] Fifty patients diagnosed with AS were divided into two groups on the basis of BMD, a normal group (n=30) and an osteopenic (n=20) group. [Results] Duration of disease in the group with a normal BMD was 10.3±7.0â years, while it was 16.7±12.2â years in the osteopenia group. MPV was high in the osteopenia group, while no significant differences were observed between the groups in terms of apparent diffusion coefficient (ADC) and platelet distribution width (PDW). There was a positive correlation between MPV and duration of disease. Correlations between ADC value and the lumbar T score, femoral neck T score, and duration of disease were insignificant. A negative correlation was observed between BMD and disease duration. [Conclusion] Diffusion-weighted imaging provides valuable results in osteoporosis but is not a suitable technique for evaluating BMD in patients with AS because of the local and systemic inflammatory effects in the musculoskeletal system. The common pathophysiology of atherosclerosis and osteoporosis plays an important role in the negative correlation observed between MPV and BMD in patients with AS.
RESUMO
OBJECTIVES: To compare individuals consuming natural spring water and tap water in terms of presence of urinary tract stone disease. PATIENTS AND METHODS: Patients were divided into two groups on the basis of the type of water: tap water (Group I) vs natural spring water consumers (Group II). The two groups were compared in terms of presence of urolithiasis. In addition to the type of water consumed, participants were investigated in terms of age, sex, occupation, body mass index (BMI) and presence of hypertension (HT) and diabetes mellitus in order to evaluate if they constituted a risk factor for urolithiasis. RESULTS: Two hundred fifty-nine patients consuming tap water and 254 consuming natural spring water were included in this study. Presence of urinary stone disease was determined in 27% of patients in Group I and 26% of Group II (p = 0.794). At multivariate analysis involving all variables that might be correlated with the presence of urolithiasis; male gender, high BMI and presence of HT emerged as being significantly associated with urolithiasis. CONCLUSIONS: Although we showed that male gender, presence of HT and high BMI affect stone formation, no difference was demonstated in terms of presence of stone among patients consuming tap or natural spring water.
RESUMO
Cesarean scar pregnancy is a very rare form of pregnancy and a life-threatening situation. It has become an important and serious problem over the last 10 years, as a result of the worldwide increase in cesarean births. In this retrospective series, the diagnosis of cesarean scar pregnancy, management, treatment methods, risk factors, and possibility of subsequent normal pregnancy are discussed, and case descriptions are presented.
Assuntos
Cesárea/efeitos adversos , Cicatriz/diagnóstico por imagem , Cicatriz/etiologia , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/etiologia , Ultrassonografia Pré-Natal/métodos , Adulto , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Gravidez , Adulto JovemRESUMO
Objective: Previous studies have shown that damage occurs to internal genital tract during hysterosalpingography (HSG). The aim was to show that endometrial and tubal epithelium underwent free radical damage during HSG in an animal model. Material and Methods: Forty rats were evaluated in five different groups. Two groups received ionizing radiation (15-20 miliRad three times) only. Two further groups received ionizing radiation in combination with iohexol (1-2 mL). The remaining group served as control. Groups were evaluated after seven and forty-two days. Inflammation and cellular changes were evaluated histopathologically. Cellular activity of antioxidant enzymes was assessed immunohistochemically. Results: Inflammation, and cellular changes were detected at certain rates in all groups (p<0.001). Glutathione reductase, catalase, superoxide dismutase, glutathione S-transferase activities were found to be increased after the HSG (p<0.001). Conclusion: It is obvious that the cell suffers acute and chronic damage during HSG due to both radioactivity and chemicals. Although there is a lot of research done before, there is no definitive method yet to protect against the harmful effects of iodinated contrast agents and ionizing radiation. So, new methods need to be explored to protect cells and tissues from reactive oxygen radical damage caused by HSG.
RESUMO
OBJECTIVE: Diabetes mellitus, smoking, dyslipidemia, and obesity play an important role in the etiology of erectile dysfunction, particularly in cases with vascular insufficiency. These risk factors also target the lungs due to their systemic effects. MATERIALS AND METHODS: Patients with penile vascular insufficiency determined at Doppler ultrasonography and undergoing thoracic computerized tomography for various reasons were included in this study. A history of acute thoracic trauma, pneumonic consolidation, or pelvic surgery and trauma were regarded as exclusion criteria. RESULTS: Thirty-seven male patients with identified vascular insufficiency (age 54.48 ± 13.62 years) were enrolled. Mass lesions with a malignant morphology were present in two patients. The most common mediastinal/vascular pathology was atherosclerosis, while the most common parenchymal lesion was emphysematous aeration. Other findings included parenchymal fibrotic bands, atelectasis, interstitial thickening, bronchiectasis, air trapping, aortic aneurysm, a dilated pulmonary artery, hiatal hernia, and pericardial effusion. CONCLUSION: Erectile dysfunction may be an early sign of cardiovascular diseases. Care must be taken in terms of existing or potential pulmonary pathologies in these patients due to their sharing common risk factors with systemic effects.
RESUMO
BACKGROUND: The aim of this study was to assess the serum L-FABP levels in patients with acute pancreatitis and compare with healthy subjects. METHODS: Thirty patients with acute pancreatitis and thirty consecutive healthy age- and sex-matched control subjects were included into the study. The serum levels of L-FABP were measured upon admission and at the remission period. RESULTS: Upon admission, serum L-FABP concentration was significantly higher in patients with acute pancreatitis compared to control subjects (41009.41 ± 32401.31 pg/ml vs. 17057.00 ± 5015.74 pg/ml, p=0.008). Serum L-FABP levels decreased after the remission period; however, the differences were not statistically significant. In addition, serum L-FABP levels showed significant correlation with AST and LDH levels. CONCLUSION: Increased serum L-FABP levels may be related to the mechanism of pancreatic microcirculatory disturbance in patients with acute pancreatitis, suggesting that serum L-FABP could be used for a potential biomarker of acute pancreatitis.
Assuntos
Biomarcadores/sangue , Proteínas de Ligação a Ácido Graxo/sangue , Pancreatite/sangue , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Microcirculação , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Índice de Gravidade de DoençaRESUMO
The aim of this prospective study was to determine the prevalence of pes anserine bursitis (PAB) in patients with osteoarthritis. A total of 85 patients with primary knee osteoarthritis diagnosed according to the American College of Rheumatology (ACR) criteria were included in the study. The patients were divided into four groups using the Kellgren-Lawrence staging system. The knee X-rays evaluated according to this system indicated that 15.6% of patients were grade 1, 34.1% grade 2, 37.1% grade 3, and 13.5% grade 4. Ultrasonography (USG) was performed on both knees by a radiologist experienced in musculoskeletal system ultrasonography and unaware of the patients' physical examination or direct X-ray findings. The presence of PAB, longest diameter of bursitis, and area of bursitis were recorded. The average age of the 11 male and 74 female patients included in the study was 58.9 ± 9.0 years. A total of 170 knees of 85 patients were examined. The incidence of bursitis was significantly higher in females (p = 0.026). The incidence of bursitis on ultrasound was 20% (34/170). There was a statistical difference between the grades for bursitis incidence (p = 0.004). There was a significant positive correlation between both the longest length (p = 0.015, r = 0.187) and area (p = 0.003, r = 0.231) of PAB with osteoarthritis grade. The mean age of bursitis patients was higher than that of those without the condition (p = 0.038). In addition, the osteoarthritis (OA) grade and bursitis prevalence increased as the patients' age increased, and these increases were statistically significant (p < 0.001). PAB is easily evaluated with ultrasonography. Pes anserine bursitis was observed in one out of every five symptomatic OA patients and was more common in female patients and with advanced age. A positive correlation was found between OA grade and PAB size and area.
Assuntos
Bursite/epidemiologia , Osteoartrite do Joelho/epidemiologia , Idoso , Bursite/complicações , Bursite/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/diagnóstico por imagem , Prevalência , Estudos Prospectivos , Turquia/epidemiologia , UltrassonografiaRESUMO
BACKGROUND: It takes years for atherosclerosis to manifest symptoms. However, it needs to be identified earlier because of the premature cardiovascular risk factors in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the effect of atherosclerosis on the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) in patients with RA. METHODS: RA patients attending the rheumatology clinic were examined retrospectively; then we called them for the measurements of ABPI and CIMT prospectively. Subjects were divided into four groups, as follows (Table 1): group 1 comprised RA patients with an ABPI less than 0.9; group 2 included RA patients with an ABPI between 0.9 and 1.2; group 3 was made up of RA patients with an ABPI greater than 1.2; and group 4 included patients without RA with an ABPI between 0.9 and 1.2 as a control group. Patients' demographic data were recorded. Hypertension (HT), diabetes mellitus, ABPI and CIMT measurements were taken by specialists. Duration of RA and disease scores (disease activity score-28, health assessment questionnaire score and visual assessment score) were recorded. RESULTS: The prevalence of peripheral vascular disease in patients with RA was twice as high as that in the normal population of equivalent age. Patients in group 2, with RA and normal ABPI, exhibited a significant higher mean in CIMT (mm) compared with the control group (p < 0.01), despite having normal ABPI. This confirms that these patients have a higher risk of stroke compared with the control group. Group 1's newly diagnosed HT (p < 0.01) and systolic blood pressure (SBP) values (p < 0.01) were higher and statistically significant when compared with the group 4 (control group); in addition, significant plaque levels were observed in the carotid arteries (p < 0.01). Group 3 patients had a similar history of HT and increased SBP compared with patients in group 4 (p < 0.01), and had similar characteristics to with group 1. No statistically significant differences were found between the groups in terms of inflammatory markers such as C-reactive protein and rheumatoid factor, anti-cyclic citrullinated peptide and white blood cell counts. CONCLUSION: Based on the present findings, patients with RA need to be evaluated in the early stage of the disease for subclinical peripheral artery disease using the ABPI, as well as CIMT, which is also a non-invasive technique, in terms of cerebrovascular events. Inflammatory markers exhibited no statistically significant difference. We think that the atherosclerotic process stems not only from the inflammatory effects of RA, but also perhaps from its immunological nature.
Assuntos
Índice Tornozelo-Braço/estatística & dados numéricos , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Espessura Intima-Media Carotídea/estatística & dados numéricos , Doenças Assintomáticas , Causalidade , Comorbidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade , Turquia/epidemiologiaRESUMO
AIMS: To evaluate renal morphology, prevalence of urinary stone disease, renal perfusion and resistance to renal blood flow in patients with ankylosing spondylitis(AS). MATERIAL AND METHODS: Thirty-eight patients diagnosed with AS and with normal basal renal functions, together with 38 healthy individuals matched in terms of age, sex, blood lipid profile and body mass index, were included. Total cholesterol, triglyceride, urea, creatinine and glucose levels were measured in both groups, as well as vitamin D, erythrocyte sedimentation rate (ESR) and C-reactive protein in the AS group. Renal dimensions, parenchymal echogenicity, presence of stone and renal resistive index (RRI) from the interlobular artery level were measured, and correlations with clinical and laboratory parameters were assessed. RESULTS: Thirty-eight patients diagnosed with AS (age 42.4+/- 11.5, 24 male, 14 women) and a control group of 38 healthy individuals (age 41.7+/-10.8, 23 male, 15 female) were included in the study. Renal stone was present in 7 patients (18.4%) in the AS group and 4 subjects (10.5%) in the control group. There was no significant difference in prevalence of stone between the groups (p=0.516). RRI values were significantly higher in the patients with AS (0.63+/-0.06) compared with the control group (0.59+/-0.03, p=0.001). Significant correlations were determined between RRI and age, triglyceride level, body mass index and length of disease. CONCLUSIONS: Renal Doppler is an important examination in early diagnosis and monitoring of renal changes in AS patients since renal complications in AS develop in the chronic and follow a subclinical course.
Assuntos
Rim/diagnóstico por imagem , Rim/fisiopatologia , Espondilite Anquilosante/diagnóstico por imagem , Espondilite Anquilosante/fisiopatologia , Resistência Vascular/fisiologia , Adulto , Biomarcadores/sangue , Glicemia , Sedimentação Sanguínea , Proteína C-Reativa , Colesterol/sangue , Creatinina/sangue , Feminino , Humanos , Cálculos Renais/sangue , Cálculos Renais/diagnóstico por imagem , Masculino , Estudos Prospectivos , Espondilite Anquilosante/sangue , Triglicerídeos/sangue , Ultrassonografia , Ureia/sangueRESUMO
A 55-year-old patient was admitted to the hospital with severe acute back pain. Thoracolumbar magnetic resonance (MR) imaging showed hemorrhage in subarachnoidal-subdural space. On cranial MR imaging and MR angiography, an aneurysm was suspected in the V4 segment of the right vertebral artery. Angiography showed a fusiform dissecting aneurysm in the V4 segment of right vertebral artery. The final diagnosis was ruptured V4 segment aneurysm with subsequent symptomatic migration of hemorrhage into the spinal subarachnoidal-subdural space. The patient was treated endovascularly by coil occlusion of both the aneurysm and vertebral artery. This rare cause and possible mechanisms for spinal migration of intracranial hemorrhage after aneurysmal rupture is discussed.
Assuntos
Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico , Hemorragia Subaracnóidea/diagnóstico , Hemorragia Subaracnóidea/etiologia , Dissecação da Artéria Vertebral/diagnóstico , Dissecação da Artéria Vertebral/etiologia , Angiografia/métodos , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: The use of intralaminar screws (ILS) in spinal surgery has experienced a recent increase in popularity. The aim of this study is to define the morphological parameters of the lumbar laminas so that guidance may be defined for ILS placement. METHODS: The study involved the evaluation of lumbar computed tomography (CT) images of patients. Two hundred thirty-five patients (127 male, 108 female) were included in the study. The mean patient age was 44.2 years (19-78 years). The measured parameters of the lamina were the transverse inner diameter, transverse outer diameter (lamina width), lamina length, subdural space (safe zone), and spinolaminar angle for each lumbar level (L1-L5). RESULTS: The mean transverse outer diameter (L1-L5) ranged from 7.2-7.8 mm, and mean transverse inner diameter ranged from 2.5-3.0 mm. The lamina of L3 had the largest width and the lamina of L1 and L5 the smallest. The mean lamina length was 26.6 mm, ranging from 21.0-34.0 mm, and the mean spinolaminar angle was 124.7°, ranging from 111-135°. The L1 level had the shortest mean lamina length and L4 the lowest spinolaminar angle. Mean subdural space (safe zone), which was narrowest at the L5 level, was 2.4 mm, ranging from 1.3-3.6 mm. CONCLUSION: ILS of the appropriate size (3.5-4.5 mm) and length (20 and 25 mm) can be used safely in the lumbar spine. However, further biomechanical studies should be performed to measure strength of the fixation.
Assuntos
Parafusos Ósseos/efeitos adversos , Vértebras Lombares/patologia , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Adulto , Distribuição por Idade , Idoso , Estudos Transversais , Estudos de Viabilidade , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Terapia de Salvação , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Spinal fusion is among the most frequently applied spinal surgical procedures. The goal of the present study was to evaluate whether the local administration of boric acid (BA) improves spinal fusion in an experimental spinal fusion model in rats. Currently, there is no published data that evaluates the possible positive effects if the local administration of BA on posterolateral spinal fusion. Thirty-two rats were randomly divided into four independent groups: no material was added at the fusion area for group 1; an autogenous morselized corticocancellous bone graft was used for group 2; an autogenous morselized corticocancellous bone graft with boric acid (8.7 mg/kg) for group 3; and only boric acid was placed into the fusion area for group 4. The L4-L6 spinal segments were collected at week 6, and the assessments included radiography, manual palpation, and histomorphometry. A statistically significant difference was determined between the groups with regard to the mean histopathological scores (p = 0.002), and a paired comparison was made with the Mann-Whitney U test to detect the group/groups from which the difference originated. It was determined that only the graft + BA practice increased the histopathological score significantly with regard to the control group (p = 0.002). Whereas, there was no statistically significant difference between the groups in terms of the manual assessment of fusion and radiographic analysis (respectively p = 0.328 and p = 0.196). This preliminary study suggests that BA may clearly be useful as a therapeutic agent in spinal fusion. However, further research is required to show the most effective dosage of BA on spinal fusion, and should indicate whether BA effects spinal fusion in the human body.
Assuntos
Transplante Ósseo/métodos , Ácidos Bóricos/farmacologia , Vértebras Lombares/efeitos dos fármacos , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Animais , Ácidos Bóricos/administração & dosagem , Vértebras Lombares/diagnóstico por imagem , Masculino , Radiografia , Distribuição Aleatória , Ratos Sprague-Dawley , Resultado do TratamentoRESUMO
PURPOSE: To assess the relation between ankylosing spondylitis (AS) and degenerative disc disease emerging in association with various intrinsic and extrinsic factors and to evaluate the correlation between degree of degeneration in intervertebral discs and apparent diffusion coefficient (ADC) values. METHODS: Thirty-five patients with AS and a control group of 35 patients were included in the study. Three hundred fifty intervertebral discs were assessed in terms of degeneration by analyzing signal intensities and morphologies on T2 weighted series of a 1.5 Tesla magnetic resonance scanner. ADC values were determined in diffusion weighted images (DWI) using a "b value of 500 s/mm(2)". Patients in the AS and control groups were compared in terms of intervertebral disc degeneration, and association between degree of degeneration and ADC values was analyzed. RESULTS: The mean of total degeneration degrees for five lumbar intervertebral discs was significantly higher in the patients with AS compared to the control group (16.77±4.67 vs 13.00±4.08, respectively; P=0.001). When intervertebral discs were analyzed separately, disc degeneration was again significantly higher in patients with AS compared to the control group, with the exception of L5-S1. Age, cholesterol level, triglyceride level, duration of disease and BASFI index were significantly associated with degree of degeneration in patients with AS. A negative correlation was determined between disc degeneration and ADC value. CONCLUSION: AS is a risk factor for degenerative disc disease due to its systemic effects, the fact it leads to posture impairment and its inflammatory effects on the vertebrae. A decrease in ADC values is observed as degeneration worsens in degenerative disc disease.