Background Plantar fasciitis due to calcaneal spur is a common cause of heel pain and functional disability, and its management presents a huge challenge for clinicians which results sometimes in unpleasant clinical outcomes. The efficacy of extracorporeal shock wave therapy (ESWT) as an alternative therapeutic option to surgical management after failure of conservative treatment has been addressed. Our aim was to evaluate the efficacy of ESWT in the treatment of plantar fasciitis in calcaneal spur patients using ultrasonography. Results The mean plantar fascia (PF) thickness was statistically significantly higher in the calcaneal spur patient group (5.66 ± 1.14 mm) than in the healthy control group (2.40 ± 0.35 mm), (P = 0.001). Significant PF thickness reduction, visual analog scale (VAS), and Roles and Maudsley score (RMS) improvement were observed (P < 0.001) after 4 sessions of ESWT. Conclusion PF thickness increases significantly in calcaneal spur patients and responds to treatment. ESWT decreases the thickness of the PF and improves pain and function significantly.

Background Intervertebral disc degeneration (IVD) is a main underlying cause for low back pain (LBP). Oswestry Disability Index (ODI) is a valuable tool used to measure patient’s low back functional outcome. Our aim is to evaluate the relation between clinical assessment of LBP and health related quality of life with the use of ODI and magnetic resonance image (MRI) findings in patients with degenerative prolapsed IVD disease. Result There was a significant correlation between Pfirrmann grades and ODI (p < 0.0001) and with type of disc morphology mostly protrusion (p < 0.0001) but insignificant correlation with visual analogue scale (VAS) (p = 0.198) and most of the clinical parameters (p > 0.05). There was a significant correlation between ODI and VAS (p = 0.003). Higher Pfirrmann grades were found at lower lumbosacral levels L4-5 and L5-S1. Conclusion Higher Pfirrmann grades correlated with the increased ODI. No association was found between MRI grading in lumbosacral spine with pain intensity and most of the clinical parameters among persons with discogenic LBP. Chronic LBP is widely accepted to be a multifactorial disorder that could not be contained within a single lumbar compartment. Clinician should not depend on MRI findings only in the diagnosis. History from the patient and clinical examination is particularly important to reach the final diagnosis. ODI might be convenient in achieving patient’s confidence and decreasing unnecessary investigations.

Objectives:To compare hearing thresholds between control subjects and rheumatoid arthritis (RA) patients, and between active and remission status. Materials and Methods:Thirty(30) Rheumatoid patients (RA group) and Twenty (20) healthy subjects (control group) were included in the study. Both groups were subjected to audiological testing: Pure tone audiometry, extended high frequency audiometry and auditory brain stem response (ABR). In RA group, the disease activity was assessed using DAS28-CRP. Results:The air conduction pure-tone hearing thresholds were significantly higher at frequencies: 2000, 4000, 8000 Hz in the RA than control group. The extended high frequency audiometry hearing thresholds were significantly higher in Rheumatoid patients at 12000 and 16000 Hz. ABR showed a significant difference between the RA and control group regarding the absolute wave Vlatency only (P<0.05).The thresholds of pure tone audiometry and extended high frequency audiometry were higher in active patients than patients with remission, with significant difference at 12000 and 16000 Hz. A significant difference was observed between the active patients and patients with remission for the absolute wave Vlatency only. There was a significant positive correlation between the hearing threshold, ABR wave V latencyand the activity of the RA patients (P<0.05). Conclusion: RA patients are at risk of hearing impairement, especially those with active disease.