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Objective: To investigate the difference between a home exercise program versus an isokinetic concentric quadriceps-hamstring exercise program in terms of functional capacity for the treatment of patients with patellofemoral pain syndrome. Material and Methods: This randomized study included 32 patients (39 painful knees) with patellofemoral pain. The patients were allocated in two groups as home exercise (HEG, n=14) and isokinetic exercise program groups (IEP, n=18). They were given an exercise program of 3 weeks. The functional status was examined with the Kujala scale, and knee muscle power was examined with the concentric isokinetic muscle test at 60 ve 180°/sc torque velocities. Results: A progression in Kujala score was observed within both groups, HEG and IEP, before and after the treatment. There was no difference with respect to improvement level between groups. In the assessment within the group before and after the treatment, including isokinetic muscle parameters, 60°/s angular velocity extension peak torque, flexion peak torque, agonist/antagonist ratio, 180°/s angular velocity flexion peak torque and agonist/antagonist ratio, flexion total work of İEG, 180°/s angular velocity extension total work, and flexion total work parameters of IEP were observed to be statistically significant. In the assessment between the groups, 60°/s angular velocity agonist/antagonist ratio and 180°/s angular velocity flexion total work were found to be significantly in favor of the IEP group. Conclusion: The isokinetic exercise program, despite being better in parameters of strengthening and endurance, was found to be similar with the home exercise program in clinical outcome in patients with patellofemoral pain. Key Words: Patellofemoral pain, exercise, isokinetic Özet Amaç: Patellofemoral ağrı tedavisinde, evde egzersiz programı ile izokinetik konsantrik kuadriseps-hamstring güçlendirme egzersizleri arasında, fonksiyonel düzelme açısından fark olup olmadığını araştırmaktı. Gereç ve Yöntemler: Patellofemoral ağrılı, 32 hasta (39 ağrılı diz) randomize olarak çalışmaya alındı. Evde egzersiz grubu (EEG, n=14) ve izokinetik egzersiz grubu (İEG, n=18) olarak iki gruba ayrılan hastalara, 3 hafta süre ile egzersiz programı uygulandı. Fonksiyonel düzey değerlendirme-sinde Kujala skalası, diz kas kuvveti değerlendirmesinde 60 ve 180°/s açı-sal hızlarda konsantrik izokinetik kas testi kullanıldı. Bulgular: Kujala skorunda, grup içi tedavi öncesi ve sonrası skorlar arasın-da her iki grupta da anlamlı iyileşme gözlendi. İyileşme düzeyi açısından gruplar arasında fark yoktu. İzokinetik kas parametreleri ile tedavi öncesi ve sonrası arasında yapılan grup içi değerlendirmede İEG'de; 60°/s açısal hızda ekstansiyon pik tork, fleksiyon pik tork, agonist/antagonist oranı, 180°/s açısal hızda fleksiyon pik tork, agonist/antagonist oranı, fleksiyon total work, EEG'de; 180°/s açısal hızda ekstansiyon total work, fleksiyon total work parametrelerinde istatistiksel olarak anlamlı düzelme gözlendi. Gruplar arası yapılan değerlendirmede...

Ankiloze omurgalar, değişen biyomekanik özelliklerinden dolayı minör travma sonrasında bile kırılma eğilimi gösterebilirler. Ankilozlu omurgadaki kırıklar, yumuşak dokuların ossifikasyonu nedeniyle genellikle instabildir ve dislokasyona neden olarak nörolojik defisit oluşturabilir. Diffüz idiyopatik iskelet hiperostozu (DISH); ileri yaşta ve erkeklerde daha sık görülen, etiyolojisi tam olarak bilinmeyen, sıklıkla vertebral kolonun anterior longitudinal ligamenti ve entezis bölgelerinde ossifikasyon ile karakterize, sistemik, noninflamatuvar bir iskelet hastalığıdır. Ossifikasyon omurganın mobilitesini azaltmakta ve ileri dönemde ankiloza yol açabilmektedir. Bu yazıda minör travma sonrası akut dönemde tanı almamış, subakut dönemde omurga fraktürü ve spinal kord yaralanması gelişmiş bir DISH olgusunun literatür eşliğinde sunulması amaçlanmaktadır.

Background A Baker's cyst is an enlargement of the gastrocnemius-semimembranosus bursa in the knee that usually communicates with the joint. Ultrasonographical examination is important for differentiation of Baker's cyst from other pathologies such as aneurysms of the popliteal artery, synovial sarcoma, and ganglia of the popliteal tendon. In addition, ultrasonography may provide guidance for safe injections. Treatment options are physical therapy, aspiration and korticosteroid injection, and surgery (1, 2). Objectives The purpose of this study was to compare the effectiveness of intraarticular and intracyst corticosteroid injections for the treatment of Baker's cyst using ultrasonographic evaluation and guidance. Methods Fifty-five patients with a clinical suspicion of Baker's cyst were evaluated with B-mode ultrasonography using a 7–13 MHz linear probe. Of these, 38 patients who were diagnosed with a Baker's cyst, is secondary to osteoarthritis were randomized into 2 groups based on injection type. The maximum transverse and longitudinal cyst areas were measured by ultrasonography, and disability was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at the first examination and again 2 and 6 weeks later. Under ultrasonographic guidance during the first examination, the Baker's cyst was aspirated directly, and 40 mg triamcinolonehexacetonide was administered via intraarticular injection (group 1) or intracyst injection (group 2). Results There was a significant reduction from baseline in the WOMAC scores and transverse and longitudinal cyst areas in both groups at week 2, while only the WOMAC scores were significantly lower in both groups at week 6 (all p<0.01). Compared to baseline, significant reductions in the transverse and longitudinal cyst areas at week 6 were only observed in the intraarticular injection group (both p<0.01), but not the intracyst injection group (both p>0.05). There was not observed any side effect. Conclusions Ultrasonography enables the diagnosis, follow-up, safe aspiration, and safe injection of Baker's cysts. Corticosteroid administered via both intraarticular and intracyst injections are effective for reductions in cyst area, pain, and disability associated with Baker's cysts; however, based on these results, intraarticular injections appear to be more effective especially in the long term. References Di Sante L, Paoloni M, Loppolo F et al. ULltrasound guided aspiration and corticosteroid injection of Baker's cyst in knee osteoarthritis: a prospective observational study. Am J Phys Med Rehabil. 2010; 89: 970-5. Bandinelli F, Fedi R, Generini S et al. Longitudinal ultrasound and clinical follow-up of Baker's cyst injection with steroids in knee osteoarthritis. Clin Rheumatol. 2012; 31: 727-31. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4138