Articular involvement was reported to be present in approximately 5-76% of Behçet patients. Therefore, we need a useful non-invasive method to detect articular involvement early in Behçet patients with nonspecific complaints. We aimed to evaluate the usefulness of 99mTc-methylene diphosphonate (Tc-99m-MDP) bone scintigraphy in the detection of the articular involvement of Behçet's disease (BD). Bone scintigraphy with Tc-99m-MDP was performed in 32 (17 male, 15 female) consecutive patients with BD. The sacroiliac (SI) joints with SI index higher than 1.34 were diagnosed as having sacroiliitis. Although joint complaints were present in only 8 (25%) patients, we detected joint involvement by scintigraphy in 27/32 (84.4%) Behçet patients mostly affecting the knees (62.5%), ankles (59.4%), SI joints (25%), wrists (21.9%), shoulders (18.7%), elbows (12.5%) and hips (3.1%). The articular involvement was monoarticular in four cases (12.5%) and was oligoarticular in the remaining. There was no correlation between joint involvement and age, gender, disease duration, drug usage or other clinical manifestations. Despite the fact that our patients were clinically asymptomatic and had normal pelvis radiography, sacroiliitis was found in 8 patients (25%). Bone scintigraphy is sensitive in the diagnosis of joint involvement allowing earlier diagnosis and showing the presence of articular involvement, especially in SI joints.

In light of the findings in these cases, bone scintigraphy is a reliable imaging method in detecting both osseous and extraosseous abnormalities of sickle cell disease and may be used initially.

Effects of the electromagnetic fields on living bodies, bones in particular, are among the relevant issues of contemporary life. In this study, we report the influences of 50 Hz and 0 Hz (static) electric fields (EF), on intact rat bones, as evaluated by dual energy X-ray absorbtion (DEXA) measurements on bone content and density when these animals (n = 27) are continuously exposed in utero and neonatally to EFs (10 kV/m) 14 days before and 14 days after their birth, for 28 days in total. Differences between 50 Hz EF and static EF groups are found to be significant (95% confidence level) for total bone mineral content (BMC), TBMC (P = .002). Differences between 50 Hz and control groups are found to be significant for total bone mineral density (BMD), TBMD (P = .002), lumbar BMC, LBMC (P = .023), and TBMC (P = .001). Differences between static EF and control groups are found to be significant for femoral BMD, FBMD (P = .009), TBMD (P = .002), LBMC (P = .001), and TBMC (P = .001). Note that TBMC parameters are jointly significant for all differences between the three groups of test animals. These results have shown that both static and 50 Hz EFs influence the early development of rat bones. However, the influence of static EFs is more pronounced than that of the 50 Hz field.

Familial Mediterranean fever (FMF) is an autosomal recessively-inherited disorder typically manifested by recurrent attacks of fever and polyserositis. The articular disease occurs in 50-70% of patients. Bone scintigraphy is more sensitive in the diagnosis of arthritis than clinical examination or conventional radiological imaging, allowing earlier diagnosis through the visualization of disease in multiple sites. To assess joint involvements in FMF patients with or without joint symptoms, bone scintigraphy was performed in 36 patients with FMF and in 25 controls. There was arthritis in 72% of patients. Of these, 65% knee, 42% ankle, 50% sacroiliac, 8% elbow, 8% wrist, 4% sternoclavicular and 4% hip involvements were found. The sacroiliac joints with sacroiliac index higher than 1.34 were diagnosed as sacroiliitis, which was higher than 2 SD of normal. FMF is frequently associated with joint disease such as knee and ankle arthritis and sacroiliitis. This high incidence of sacroiliitis in our study has not been previously reported. This difference could be explained by the different methodology used for the screening of the joints. Thus, we recommend that bone scintigraphy can be used in patients with FMF to determine the presence of arthritis, especially in sacroiliac joints, even asymptomatic.

ÖZETAmaç: Behçet hastalığı (BH)'nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak osteoporoz gelişebilir. Çalışmanın amacı BH'nda osteoprotegerin ve tümor nekroz faktör (TNF-α) düzeyleri ve bunlar arasındaki korelasyonu araştırmaktır. Gereç ve yöntem:Çalışmaya, hasta grubu ve kontrol grubu olarak iki grup alındı. TNF-α, osteoprotegerin, osteokalsin, sedimantasyon, CRP, idrar kreatin ve deoksipridinolin düzeyleri ile beraber kemik mineral dansitometrisi (KMD) ölçüldü ve iki grup karşılaştırıldı. Bulgular: Çalışma grubuna 41 hasta, kontrol grubuna 36 hasta alındı. Çalışma ve kontrol grubunun yaş ortalaması sırasıyla 42.26±11.64 ve 41.66±70.99 bulundu. Vücut kitle indeksi yönünden iki grup arasında fark bulunmadı. TNF-α (p<0.001), deokspiridinolin (p<0.001) ve osteokalsin (p=0.041) düzeyleri kontrol grubundan önemli oranda yüksek bulundu. Osteoprotogerin düzeyi hasta grubunda düşüktü ancak anlamlı düzeyde değildi (p>0.05). İdrar deoxypyridinoline/ idrar kreatinin oranı hasta grubunda kontrol grubuna göre anlamlı yüksekti (p=0.03). Hasta grubun KMD ölçümü; L2-L4 hariç, kontrol grubuna göre anlamlı oranda düşüktü (sırasıyla p<0.001, p<0.001, p=0.035, p<0.001, p=0.012, p<0.001, p<0.001 ve p=0.111). TNF-α ve osteoprotegerin arasında korelasyon saptanmadı.Sonuç: Bu çalışmada TNF-α ve KMD arasında negatif korelasyon saptandı ve TNF-α'nın, BH'da osteoporotik süreci etkilediği bulundu. Osteoprotogerin düzeyi düşük-lüğü anlamlı değildi ve TNF-α ile korele değildi.Anahtar kelimeler: Behçet hastalığı, osteoprotegerin, TNF-α, osteokalsin ABSTRACT Objectives: Osteoporosis is commonly developed due to natural course of Behçet's disease (BD) and therapeutic agents. It was aimed to investigate levels of osteoprotegerin and TNF-α (tumor necrosis factor), and bone mineral density (BMD) and correlation between them in BD. Materials and methods:The study included two groups as the study and the control group. Serum levels of TNF-α, osteoprotegerin, osteocalcine, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and urinary creatinine and deoxypyridinoline along with BMD level were evaluated and compared. Correlation between TNF-α and osteoprotegerin level was investigated. Results:The study enrolled 41 BD patients and 36 agedmatched control subjects. Mean age was 42.26±11.64 and 41.66±70.99, in the study and control groups, respectively. There was no significant difference in body mass index (BMI) of subjects between groups (p>0.05). Level of TNF-α (p<0.001), deoxypyridinoline (p<0.001) and osteocalcine (p=0.041) was significantly higher in the study group compared to the control group. Osteoprotegerin was lower in BD patients, but the difference was not significant (p>0.05). Urinary deoxypyridinoline/ urinary creatinine ratio in patients with BD was significantly higher than those in control group (p=0.030). Patients had significantly lower BMD comparfed to the control group, except L2-L4 vertebral area (p<0.001, p<0.001, p=0.035, p<0.001, p=0.012, p<0.001, p<0.001 and p=0.111, respectively). No correla...