‹nmeli Hastalarda Yaflflam Kalitesini Etkileyen ... - FTR Dergisi

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23. Ulusal Fiziksel T›p ve Rehabilitasyon Kongresi / 23 rd National Physical Medicine & Rehabilitation Congress
Türk Fiz Rehab Derg 2011:57Özel Say›; 1-334 /Turk J Phys Med Rehab 2011:57Suppl; 1-334
P-017
Kalça A¤r›s› ile Klinik Bulgu Veren Bir Primer Hiperparatiroidi Olgusu
Aylin Karaman, Özlem Solak
Afyon Kocatepe Üniversitesi T›p Fakültesi Fiziksel T›p ve
Rehabilitasyon Anabilim Dal›, Afyonkarahisar
Primer hiperparatiroidizm paratiroid glandlar›ndan afl›r› derecede parathormon sal›n›m› ile
giden ve en çok paratiroid adenomuna ba¤l› ortaya ç›kan bir hastal›kt›r. S›kl›kla asemptomatik
seyreden bu hastal›k de¤iflik sistem ve organlar› ilgilendiren bulgularla ortaya ç›kabilir.
Semptomatik vakalar ise halsizlik, yorgunluk, ifltahs›zl›k, poliüri, polidipsi, kas iskelet sistem
a¤r›lar› ile gelebilir. Biz bu olgu sunumunda her iki kalçada ve omuzda fliddetli a¤r› ve yürüyememe
flikayeti ile gelen 72 yafl›nda bayan hastam›z› sunuyoruz.Hastam›z›n fizik muayenesinde
kalça ve omuz eklem hareket aç›kl›klar› k›s›tl› ve a¤r›l›yd›. Laboratuvar tetkiklerinde
parathormon yüksekli¤i olmas› üzerine çekilen paratiroid ultrasonografisinde paratiroid adenomu
tespit edildi. Biz bu olgu sunumunda yürüyememe ve fliddetli eklem a¤r›lar› ile gelen
hastalarda paratiroid patolojilerini de düflünmek gerekti¤ini vurgulamak istedik.
Anahtar Kelimeler: Kalça a¤r›s›, primer hiperparatiroidizm, yürümede güçlük
P-018
Çocuk Hastada A¤r›s›z Diskoid Lateral Menisküs ve Meniskal Y›rt›k:
Vaka Sunumu
Mehmet Adam1 , P›nar Doruk1 , Berrin Leblebici 1 , fienay Demir2 1Baflkent Üniversitesi Adana Araflt›rma ve Uygulama Merkezi,
Fizik Tedavi ve Rehabilitasyon Klini¤i, Adana
2Baflkent Üniversitesi Adana Araflt›rma ve Uygulama Merkezi, Radyoloji Klini¤i, Adana
Çocuk hastalarda kas iskelet flikayetlerinin de¤erlendirilmesi, yetiflkin hastalara göre
farkl›l›klar ve daha fazla önem arz etmektedir. Bu farkl›l›klar›n nedenlerinden baz›lar›, konjenital
durumlar›n ve geliflimsel durumlar›n bu grupta kendini göstermesi, organizman›n h›zla
büyümesi, daha aktif bir yaflant› sürmesiyle travmalara daha yatk›n olabilmesi ve çocukluk
yafl grublar›na göre baz› hastal›klar›n daha s›k gözlenebilmesidir.
Bu olgu sunumunda belirgin travma öyküsü tariflemeyen a¤r›s›z diskoid lateral menisküs ve
y›rt›¤› tart›fl›lacakt›r.
OLGU: Sekiz yafl›nda erkek hasta, yaklafl›k bir y›ld›r travma olmaks›z›n sa¤ dizini açamama
flikayeti ile poliklini¤imize baflvurdu. Sa¤ dizde flifllik, k›zar›kl›k tariflemiyordu. A¤r› flikayeti de
olmayan hastan›n ailesi çocu¤un aktif yaflant›s›n›n devam ettirdi¤ini, ancak koflarken dizin
tam aç›lmad›¤›ndan yak›n›yorlard›. Özgeçmifl ve soygeçmiflinde özellik olmayan çocu¤un sistemik
muayenesi normal idi. Sa¤ dizde efüzyon yok idi, palpasyonda hassas nokta yok idi,
eklem hareket aç›kl›¤› a¤r›s›z, ancak ekstansiyonu 10 derece limitli idi. Meniskal testleri
negatifti. Kas gücü normaldi.
Tam kan say›m›, eritrosit sedimantasyon h›z›, CRP, rutin biyokimya ve 2 yönlü konvansiyonel
diz grafileri normal s›n›rlarda idi. Germe egzersizleri önerilen hastaya 3 hafta sonraki kontrolde
flikayet ve muayene bulgular›nda de¤ifliklik saptanmad›. Sa¤ diz manyetik resonans
incelemesinde lateral menisküs diskoid görünümü ve horizontal y›rt›k saptand›. Hastan›n
flikayetinin a¤r›s›z olmas› ve meniskal y›rt›k bulgular›n›n aflikar olmamas› nedeniyle konservatif
tedavi planlad›.
Mevcut olgumuz eflli¤inde çocukluk yafl grubunda diskoid menüsküs ve y›rt›¤› tart›fl›lacakt›r.
Anahtar Kelimeler: A¤r›s›z, diskoid lateral menisküs, y›rt›k
P-017
A Case of Primary Hhyperparathyroidism with Clinical Signs of Hip Pain
Aylin Karaman, Özlem Solak
Afyon Kocatepe University School of Medicine Department of
Physical Medicine and Rehabilitation, Afyonkarahisar
Primary hyperparathyroidism is a disease that progresses with extreme parathormone
secretion from parathyroid glands and is mostly related to parathyroid adenoma. This disease,
which is usually asymptomatic, can manifest clinical symptoms related to various systems
and organs. Symptomatic cases may appear with weakness, fatigue, anorexia, polyuria,
polydipsia and musculoskeletal system pains. In this case presentation, we are presenting a
72 year old female patient who had the complaint of extreme pain in shoulder and both hips
and difficulty in walking. The range motion of hips and shoulder of the patient was found to
be painful and restricted in the patient’s physical examination. Since laboratory examination
revealed an increase in parathormone level, parathyroid ultrasonography was performed and
a parathyroid adenoma was detected. In this case presentation, we wanted to draw your
attention to the fact that parathyroid pathologies should also be taken into consideration in
the patients with complaints of difficulty in walking and extreme outrage.
Keywords: hip pain, primary hiperparathyroidism, difficulty in walking
P-018
Painless Lateral Discoid Meniscus and Meniscal Tear in a Child Patient:
A Case Report
Mehmet Adam1 , P›nar Doruk1 , Berrin Leblebici 1 , fienay Demir2 1Baskent University, Adana Teaching and Research Center, Physical Medicine and
Rehabilitation Department, Adana
2Baskent University, Adana Teaching and Research Center,
Radiology Department, Adana
The assessment of musculoskeletal complaints in childhood differs from adults and concerns
more importance. Some of the causes of the difference are the presence of special
congenital and developmental states in this group, rapid growth of the organism, tendency
to traumas because of more active daily life and increased incidence of some diseases in
childhood. In this case, we report a painless lateral discoid meniscus and tear without any
prominent trauma history.
CASE: Eight year old boy was admitted to our clinic with the complaint of being unable to
extend his right knee for 1 year, without a history of trauma. There was no pain, swelling and
rash on the right knee. The parents reported that the boy had no problems in daily life but
was unable to extend his knee while running. The patient and family histories showed no
peculiarities and his systemic physical examination was normal. There was no effusion on the
right knee, no tender points on palpation, no pain on range of motion of the joint, but the
extension was limited to 10 degrees. Meniscal tests were negative and muscle strength
was normal. Complete blood count, erythrocyte sedimentation rate, C-RP, biochemical
examination and anteroposterior and lateral conventional knee x-rays were in normal ranges.
Stretching exercises were given to the patient, but showed no improvement in complaints
and physical examination findings after 3 weeks. Magnetic resonance imaging of right knee
showed discoid appearance of lateral meniscus and a horizontal tear. Conservative treatment
was planned since the patient was painless and the findings of meniscal tear were not
evident. Childhood discoid meniscus and tear will be discussed in accompaniment to our case.
Keywords: Painless, disciod lateral meniscus, tear