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Background: Myofascial pain syndrome (MPS) is a musculoskeletal disorder, that results from trigger points, which are small, taut skeletal muscle and fascia. Objective: To compare the efficacy of Extracorporeal Shock Wave Therapy (ESWT) versus corticosteroid injection in the treatment of patients with MPS of the upper trapezius muscle. Patients and Methods: This prospective randomized study included fifty patients with MPS who were randomly divided equally into two groups. The active myofascial trigger points (MTrPs) in the upper trapezius were identified. Group 1 patients received ESWT 3 times at one-week intervals and group 2 patients received one injection of corticosteroids. The visual analog scale (VAS), Neck Disability Index (NDI), and pain pressure threshold (PPT) assessed the outcomes. Results: VAS scores were 7.24±1.01, 3.72 ±1.43 and 2.44±1.36 at baseline, week-4 and -8 respectively in group1; while were 7.16±1.03, 5.76 ±1.16 and 5.24±1.48 at baseline, week-4 and -8 respectively in group2. NDI scores were 11±2.63, 7.92±2.63 and 6.52±2.66 at baseline, week-4, and -8 respectively in group1, whereas were 11.16±2.36, 8.72±2.37 and 7.64±2.66 at baseline, week-4 and -8 respectively in group2. PPT scores were 2.81±0.70 at baseline, and 4.64 ±1.03 and 5.54±1.1 at week-4 and week-8 in group1, while, in group2 the scores were 2.89±0.71, 3.92 ±0.81 and 4.08±0.92 at baseline and week-4 and -8 respectively. VAS, NDI, and PPT pre-and post-treatment results showed statistically significant improvements in both groups, P <0.001. Conclusion:ESWT and corticosteroid injection considerably reduced pain intensity, physical impairment, and MTrP sensitivity to pressure in patients with MPS. ESWT was more effective in the reduction of pain and MTrPs sensitivity to pressure.

Introduction: Both primary osteoarthritis (OA) and age-related macular degeneration (AMD) cause disability in old people. This study aimed to detect the relation between primary osteoarthritis and age-related macular degeneration in a sample of geriatric Egyptian population. Methods: This cross-sectional study included 222 primary OA patients. Medical history, musculoskeletal examination, body mass index (BMI) calculation, and ophthalmological examination, radiographs of anteroposterior view and weight-bearing position for both hips and both knees and posteroanterior view for hands, Kellgren and Lawrence grading score for radiological severity of OA, optical coherence tomography (OCT), and fundus fluorescence angiography FFA for evaluation of the macula were done. AMD was classified into early, intermediate, and late. The collected data were analyzed using SPSS version 25.0. Results: Forty-six OA patients had AMD [19 cases had early, 15 cases had intermediate and 12 cases with late (7 neovascular (NV) and 5 geographic atrophy (GA))]. There was a significant correlation between AMD stages and OA grading score. There were significant differences between OA patient with AMD and those without AMD regarding age, disease duration, disease severity, family history of OA, daily mild exercise and calcium, and vitamin D intake. Multivariable analysis revealed that older age, more severe OA, low exercise and less calcium and vitamin D intake were considered independent risk factors for AMD development in primary OA. Conclusion: Primary OA patients are more liable to AMD due to common risk factors and related pathogenesis. Ophthalmological follow up of those patients is recommended.