Objectives. The aim of this study was to investigate the relationships between pain, disability, and radiographic findings in patients with knee osteoarthritis (OA). Patients and Methods. A total of 114 patients with knee OA who attended the physical medicine and rehabilitation outpatient clinic were included in this study. The diagnosis was based on the American College of Rheumatology (ACR) criteria for knee OA. Age, duration of disease, and body mass index (BMI) of the patients were recorded. Radiographic features on the two-sided knee radiography were assessed with the Kellgren-Lawrence scale. The severity of knee pain, stiffness, and disability were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The mean age of the patients was 56.98 (±8.28) years and the mean disease duration was 4.14 (±4.15) years. Kellgren-Lawrence grading scale and age or disease duration were positively and significantly associated, whereas none of the WOMAC subscores were found to be related with Kellgren-Lawrence grading scale (P > 0.05). On the other hand, WOMAC disability scores were significantly associated with WOMAC pain and WOMAC stiffness (P < 0.01). Conclusions. Knee pain, stiffness, and duration of disease may affect the level of disability in the patients with knee OA. Therefore treatment of knee OA could be planned according to the clinical features and functional status instead of radiological findings.

The purpose of this study was to investigate the clinical effects of balneotherapy in the treatment of Fibromyalgia Syndrome (FMS) and to determine if balneotherapy influences serum levels of inflammation markers, IL-1, PGE2 and LTB4. 24 primary fibromyalgia female patients diagnosed according to American College of Rheumatology criteria were included to the study. Their ages ranged between 33 and 55 years. FMS patients were randomly assigned in two groups as, group 1 (n = 12) and group 2 (n = 12). Group 1 received 20-min bathing, once in a day for five days per week. Patients participated in the study for 3 weeks (total of 15 sessions) in Denizli. Group 2 did not receive balneotherapy. FMS patients were evaluated by tenderness measurements (tender point count and algometry), Visual Analogue Scale, Beck's Depression Index, Fibromyalgia Impact Questionnaire. Ten healthy women recruited group three as the controls. Serum PGE2, LTB4 and IL1-alpha levels were measured in all three groups. The biochemical measurements and clinical assessments were performed before and at the end of general period of therapy. Statistically significant alterations in algometric score, Visual Analogue score, Beck's Depression Index and PGE2 levels (P < 0.001), numbers of tender points (P < 0.01) and Fibromyalgia Impact Questionnaire score (P < 0.05) were found after the balneotherapy between group 1 and 2. Mean PGE2 level of FMS patients were higher compared to healthy control group (P < 0.0001) and decreased after the treatment period, only in group 1 (P < 0.05). As in the group 2 and 3, detectable IL-1 and LTB4 measurements were insufficient, statistical analysis was performed, only in group 1. After balneotherapy IL-1 and LTB4 significantly decreased in group 1 (P < 0.05). In conclusion, balneotherapy is an effective choice of treatment in patients with FMS relieving the clinical symptoms, and possibly influencing the inflammatory mediators.

The aim of this study was to investigate the effects of intra-articular hyaluronic acid (HA) on symptoms, functional outcome, and changes in articular cartilage assessed by magnetic resonance imaging (MRI) in patients with knee osteoarthritis. Thirty patients were randomly assigned to treatment with HA (hylan G-F 20, Synvisc) or saline. The treatment group consisted of 20 patients receiving three weekly injections of HA into one or both knees (30 knees). The control group consisted of ten patients receiving three intra-articular injections of 2 ml saline at the same intervals (ten knees). To determine the effectiveness of the HA therapy, all patients were assessed prior to the injections (baseline) and after the 1st, 2nd, 3rd, and 8th weeks. Assessment comprised the following: pain at rest, at night, and on walking using a visual analogue scale (VAS); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and function scores; 15-m walking time; need for analgesics; and evaluation of treatment by the patients. MRI of patellofemoral (PF) articular cartilage was also examined before and after the course of injections at the 8th week. When compared to placebo, a significant statistical difference was found in all clinical parameters. On MRI, although the difference in the PF joint cartilage quality in the HA group before and after the treatment was statistically significant (p < 0.05), this significance was not detected between the groups after the treatment (p > 0.05). After the HA injections, a significant analgesic effect was seen as early as the 3rd week continuing up to the 8th week and functional improvement was seen at the 8th week. In conclusion, intra-articular injections of HA is an effective choice of treatment in patients with knee osteoarthritis.

The aim of this study is to evaluate the types and clinical characteristics of peripheral facial palsy in children. The hospital charts of children diagnosed with peripheral facial palsy were reviewed retrospectively. A total of 81 children (42 female and 39 male) with a mean age of 9.2 ± 4.3 years were included in the study. Causes of facial palsy were 65 (80.2%) idiopathic (Bell palsy) facial palsy, 9 (11.1%) otitis media/mastoiditis, and tumor, trauma, congenital facial palsy, chickenpox, Melkersson-Rosenthal syndrome, enlarged lymph nodes, and familial Mediterranean fever (each 1; 1.2%). Five (6.1%) patients had recurrent attacks. In patients with Bell palsy, female/male and right/left ratios were 36/29 and 35/30, respectively. Of them, 31 (47.7%) had a history of preceding infection. The overall rate of complete recovery was 98.4%. A wide variety of disorders can present with peripheral facial palsy in children. Therefore, careful investigation and differential diagnosis is essential.

The aim of this study was to describe clinical features of Bell's palsy (BP) in children and outcomes of physical therapy interventions. Medical records of 186 patients with diagnosis of BP were reviewed. The severity of facial nerve dysfunction was graded according to House Brackmann Facial Nerve Grading Scale (HB FGS). After one month, patients who had HB FGS grade three or more were included in a physical therapy programme consisting of superficial heat, massage, exercises, and electrical stimulation. Among 186 children with BP, 167 children had a severity of HB FGS grade three or more and 19 had the incomplete type at the time of the diagnosis. After one month follow-up, 144 patients fully recovered, 35 patients recovered partially, while 7 patients had no recovery. Patients who had not fully recovered one month after onset of paralysis were included in the physical therapy programme. There was statistically significant difference between pretreatment and posttreatment HB FGS scores in patients who had not fully recovered one month after onset of paralysis. We concluded that the prognosis of BP in children seems to be good with higher recovery rate and physical therapy programme might be an effective method to facilitate recovery in patients with poor prognosis.