Ultrasonographic Evaluation of the Distal Femoral Cartilage Thickness in Parkinson's Patients.

OBJECTIVES: Both Parkinson's disease (PD) and osteoarthritis (OA) are characterized by chronic inflammation and tissue degeneration. The aim of this study is to investigate the relationship between PD and distal femoral cartilage thickness (DFCT). Our study is the first in the literature to measure DFCT in PD. METHODS: 68 patients with PD and 30 healthy individuals participated. The patient group was divided into three subgroups, according to the Hoehn Yahr stages (HYS): mild, moderate and severe. Patient subgroups and the control group were compared with each other in terms of neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), and DFCT. RESULTS: The NLR and CRP levels of the PD patients were higher than the values of the healthy people. The DFCT values of the mild PD subgroup were significantly higher than those of the control group, except for one value. The DFCT values of the moderate PD subgroup and the healthy group were similar. The DFCT values of the severe PD subgroup were lower than the values of the healthy group. CONCLUSIONS: Our study showed the presence of ultrasonographic evidence consistent with early signs of cartilage destruction in early-stage PD disease. As the PD stage progressed, the cartilage thickness decreased accordingly.

Investigation of the Association between Headache Type, Frequency, and Clinical and Radiological Findings in Patients with Multiple Sclerosis.

AIM: In this study, we aimed to investigate the prevalence of primary headaches in patients with multiple sclerosis (MS), to determine the type of headache according to the criteria of International Headache Society and to investigate the relationship between primary headache type and MS subtype, and the relationship between the localization of plaques in the brain magnetic resonance imaging (MRI) with MS clinic. METHODS: In this study, we include the patients diagnosed with MS according to the Mc Donald criteria and functional loss determined with Expanded Disability Status Scale (EDSS). We include the patients who were questioned about headache characteristics in detail and the patients who have MRI previously. MRI evaluations of plaque localization of the patients were classified retrospectively. FINDINGS: Headache in 54.4% of 320 patients participated in the study are available (23.8% tension-type headache (TTH), 30.6% migraine). When we look at the first three initial symptoms of MS patients, the patients who have polysymptomatic symptoms at the beginning are 25.3%, those with motor symptoms are 23.1%, and patients with optical symptoms are 19.7%. The mean EDSS was 2.6 ± 1.9. When we look the lesion localization, at most pericallosal lesions are present. Mean disease duration was 9.9 years in patients with TTH and 4.5 years in patients with migraine. The difference was statistically significant (P < 0.05). The mean EDSS score was 4.7 in patients with TTH and 1.8 in patients with migraine, and the difference was statistically significant (P < 0.001). The average number of lesions in the brain was 22.07 in patients with TTH and 15.79 in patients with migraine. The difference was statistically significant (P < 0.001). RESULTS: In this study, the frequency of headache in MS patients was found to be greater than the general population and we found a higher incidence of migraine-type headache in these patients. We observed that the tension type of headache is more frequent in MS patients with higher ages, longer disease duration, more plaque numbers, and high EDSS scores.

Assessment of the Anterior Talofibular Ligament Thickness in Patients with Chronic Stroke: An Ultrasonographic Study.

BACKGROUND: Patients with equinovarus deformity have an increased risk of fall and ankle ligament injury, because of inappropriate prepositioning of the ankle at the end of the swing phase, and inadequate leg and ankle stability during the stance phase. Accordingly, the aim of this study is to compare anterior talofibular ligament (ATFL) thickness of chronic stroke patients with that of healthy individuals using ultrasonography. METHODS: This was a case-control study conducted in a university hospital between July 2015 and July 2016. We included 38 patients [study group; mean age, 59.0 ± 11.1 years; mean body mass index (BMI), 25.4 ±4.3 kg/m2] and a control group of age-, sex-, and BMI-matched healthy individuals. Demographic and clinical characteristics of the patients (i.e., age, weight, height, Brunnstrom motor recovery stage, Functional Ambulation Scale, Ashworth Scale, and duration of hemiplegia) were recorded during their visits. Furthermore, ultrasound image of the ATFL was obtained from each ankle. The thickness of the ATFL was measured at the midpoint of the ligament between the attachments on the lateral malleolus and the talus using ultrasonography. RESULTS: In the study group, the mean thickness of the ATFLs of the affected side (2.75 ± 0.41 mm) was thicker than both the unaffected side (2.42 ± 0.30 mm) and the healthy controls (2.35 ± 0.19 mm; p = 0.007, p < 0.001, respectively). No differences were seen between the two sides of the control group. CONCLUSION: Chronic stroke patients have a thicker ATFL on both the affected and unaffected sides, compared with healthy individuals. This architectural feature of the ATFL may be a result of equinovarus deformity together with spastic muscles. For this reason, early treatment of deformed ligaments and spastic muscles is needed to prevent equinovarus deformity in patients with stroke.