Osteoarthritis is no longer considered a degenerative disease. The presence of underlying low-grade inflammation has been well demonstrated. Although osteophytes are used to determining the radiological stage, the development mechanism is not fully understood. The aim of this study is to separately evaluate the relationship between various inflammation parameters associated with complete blood count with osteophytes and radiological stage. Methods:Patients who met the American College of Rheumatology clinical knee osteoarthritis criteria, retrospectively selected. Kellgren-Lawrence grading scale was used for disease severity and Osteoarthritis research society international grading was used for osteophyte size evolution. Red blood cell distribution width, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, neutrophil to monocyte ratio, lymphocyte to monocyte ratio, and mean platelet volume obtained from complete blood count, and C-reactive protein levels were recorded. The relationship between inflammation markers and osteophytes and disease stage was evaluated by logistic regression analysis. Results:A significant correlation was shown between CRP and PLR in the early stage of the disease. No correlation was found in advanced stage. No correlation was found between osteophyte progression and inflammatory markers in the analysis based on osteophyte size. Conclusion:In this study, we have shown that there is a relationship between systemic low-grade markers of inflammation and early stages of knee osteoarthritis, but this relationship was not detected in advanced stages. There was not a relation between osteophyte progression and these markers. Even though it seems to be running together, we can assume that the progression of the disease and osteophyte formation have different mechanisms.

Calcaneal apophysitis is a condition known also sever disease. Recent knowledge supports overuse injury as an underlying etiology. The typical presentation is bilateral or unilateral heel pain during an activity in an adolescent who had a history of new-onset sports activity. We should take a detailed history, careful examination and simple laboratory tests for the patients with painful heels. If the patient's symptoms and examinations fit with calcaneal apophysitis some authors believe no need for radiography, unlike routine practice. MRI and ultrasound can also provide helpful diagnostic images but are neither cost-effective nor easy accessible at the first stage. We need to improve our knowledge and confidence in the clinical workup. Obviously further investigations require to reveal an ideal diagnostic algorithm.

Ayakta ağrı ve şişlik; travmatik, enflamatuar ve mekanik nedenler gibi geniş bir etyolojik tabloya bağlı olabilir. Öykü, fizik muayene ve radyolojik değerlendirme ile ayırıcı tanı yapılması gerekebilir. Atipik öykü ve rutin değerlendirmelerle tanı konulamadığında ileri radyolojik tetkikler yapılması gereklidir. Kalkaneus, stres kırıklarının nadir görüldüğü bir kemiktir. Stres kırıkları yorgunluk ve yetersizlik kırığı olmak üzere ikiye ayrılır. Aşırı aktiviteye bağlı olarak normal kemikte oluşan stres kırıkları yorgunluk kırığı; normal ve fizyolojik bir yüklenmeyle oluşan elastik rezistansı azalmış kemikteki kırıklarsa yetersizlik kırığı olarak sınıflandırılır. Burada topuk ağrısı nedeni ile başvurduğunda yapılan ilk değerlendirmelerde radyografisi normal olarak değerlendirilen, takibinde yakınmaların devam etmesi üzerine çekilen manyetik rezonans görüntülemesinde kalkaneusta, pes kavus deformitesine bağlı olduğu düşünülen stres kırığı saptanan ve kompleks bölgesel ağrı sendromu gelişen bir olgu sunulmuştur.