‹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-021
Kondrokalsinosiz: Bir olgu sunumu
Mehmet Adam, P›nar Doruk, Berrin Leblebici
Baflkent Üniversitesi Adana Araflt›rma ve Uygulama Merkezi
Fizik Tedavi ve Rehabilitasyon Klini¤i, Adana
Kalsiyum pirofosfat dihidrat (KPD) depo hastal›¤›, ilk defa 1857 y›l›nda Adams taraf›ndan
tan›mlanan, hyalin ve fibrokartilaj k›k›rdakta KPD kristallerin birikti¤i bir hastal›kt›r. Bu
kristaller, psödogut olarak bilinen bir inflamatuvar artriti oluflturabilir. Pirofosfat artropatisi
ise daha yayg›n, ciddi, atipik da¤›ml› yap›sal eklem hasar› oluflmas› durumunda kullan›l›r.
Kondrokalsinosiz terimi, k›k›rdak kalsifikasyonunu patolojik ya da radyolojik olarak gösterilmesi
için kullan›l›r.
OLGU: Altm›fl befl yafl›nda erkek hasta, yaklafl›k alt› ayl›k diz a¤r›s› flikayeti ile FTR poliklini¤ine
baflvurdu. Hiç fliflli¤i olmayan hastan›n a¤r›lar› aktivite ile art›yormufl. Özgeçmifl ve
soygeçmiflinde bir özellik saptanmayan hastan›n fizik muayenesinde sistemik muayene normal
s›n›rlarda idi. Her iki diz eklem hareket aç›kl›¤› normal, efüzyonu saptanmad›. Eklem
hareketi ile patellofemoral krepitasyonu saptand›.
Tetkiklerinde rutin tam kan say›m›, CRP, eritrosit sedimantasyon h›z› ve biokimyas› normal
s›n›rlarda idi. Konvansiyonel x-ray grafilerinde her iki diz meniskal kalsifikasyonu saptand›.
Kondrokalsinosiz teflhisi ile hastaya 15 seans hot-pack, ultrason, TENS ve egzersiz tedavisi
uyguland›. Oldukça rahatlayan hasta ev program› önerildi. Üçüncü ay kontrolünde diz a¤r›
flikayetleri kalmayan hastaya egzersizlerine devam etmesi önerildi.
Mevcut olgu eflli¤inde kondrokalsinosiz tart›fl›lacakt›r.
Anahtar Kelimeler: Diz, a¤r›, kondrokalsinosiz
P-022
Kompleks Bölgesel A¤r› Sendromlu Hastalar›m›z›n Klinik Özellikleri
Emre Lakfle 1, Ferda Erkifli 1, Tolga Kaplan 2
1 Bursa Medical Park Hastanesi Fizik Tedavi ve Rehabilitasyon Bölümü, Bursa
2 Bursa Medical Park Hastanesi Ortopedi ve Travmatoloji Bölümü, Bursa
AMAÇ: Bu çal›flman›n amac› kompleks bölgesel a¤r› sendromlu (KBAS) hastalar›m›z›n
demografik, klinik özelliklerinin belirlenmesi ve paylafl›lmas›d›r.
GEREÇ-YÖNTEM: 2008-2010 y›llar› aras›nda hastanemizde tan› alan KBAS’lu toplam 75 hastan›n
hastane otomasyon verilerine ulafl›larak klinik, demografik özellikleri retrospektif analiz
edildi.
BULGULAR: Yetmifl befl hastan›n %49'u kad›nd›(K/E: 37/38). Yafl ortalamas› 48,6±4,8 idi.
Etyoloji incelendi¤inde 69 hastada k›r›k hikayesi, 3 hastada tendon tamiri hikayesi,1 hastada
serebrovasküler olay, 1 hastada yumuflak doku travmas› ve 1 hastada da karpal tünel sendromu
ameliyat› hikayesi vard›. K›r›¤› olan hastalar›n 5’inde araçl› trafik kazas› ve 3’ünde ifl kazas›
öyküsü vard›.Muayene bulgular›nda hastalar›n hepsinde a¤r› ve ödem mevcuttu. Allodini
oran› %12 idi. 16 hastada osteoporoz (%21) vard›. K›r›klar›n %52’si alt ekstremitede idi ve en
s›k 24 hasta ile ayak bilek k›r›¤› sonras›nda 6 hastada tibia, 4 hastada ayak bölgesi ve 1’rer hastada
patella ve femur k›r›¤› mevcuttu. Üst ekstremite k›r›klar›nda ise %82 ile en s›k colles fraktürü
görülüyordu sonras›nda ise 12% ile humerus k›r›¤› ve %3 ile de önkol k›r›¤› vard›.
Ortalama alç› süresi 44,2±9,1 gündü. Tüm hastalara fizik tedavi ve rehabilitasyon program›
önerilmiflti fakat kat›l›m oran› %52 idi. Ortalama terapi süresi ise 16,2±6,9 gündü. Fizik tedavi
ve rehabilitasyon gören hastalar›n tedavi sonras›nda %61’inde a¤r›, flifllik ve hareket k›s›tl›l›¤›
kalmam›flt›.
SONUÇ: KBAS’lu hastalar›m›z›n demografik ve klinik özellikleri önceki çal›flma sonuçlar›na
benzerlik gösteriyordu. Ancak bizim çal›flmam›zda etyolojide k›r›k say›s› daha s›k idi.
Anahtar Kelimeler: KBAS, rehabilitasyon, k›r›k
P-021
Chondrocalcinosis: A Case Report
Mehmet Adam, P›nar Doruk, Berrin Leblebici
Baflkent University Adana Teaching and Research Center Physical Medicine and
Rehabilitation Department, Adana
Calcium pyrophosphate dihydrate (CPD) deposition is a disease that CPD crystals
accumulated in hyaline and fibro-cartilage and firstly defined by Adams at 1857. These
crystals can produce an inflammatory arthritis known as pseudogout. The term of pyrophosphate
arthropathy is used when there are diffuse, severe and atypically distributed structural
joint damages. Chondrocalcinosis is a term that used for pathological and radiological
demonstration of the cartilage calcification.
CASE: Sixty-five year old man was admitted to our clinic with a complaint of knee pain for 6
months. He never had joint swelling, his knee pain was increasing with activity. The patient
and family backgrounds showed no peculiarities and the systemic physical examination was
normal. The range of motion of both knees were full and there was no effusion. There was
patellofemoral crepitus with the joint motions. Meniscal calcification was detected at both
knees by conventional x-rays. It was diagnosed as chondrocalcinosis and 15 sessions of hotpack,
ultrasound, TENS and exercises were applied. Patient's complaint was significantly alleviated
and a home program was suggested. After 3 months, his knee pain was relieved. He
was proposed to keep on exercising.
Chondrocalcinosis will be discussed in accompaniment with our case.
Keywords: Knee, pain, chondrocalcinosis
P-022
Clinical Features of Patients with Complex Regional Pain Syndrome
Emre Lakfle 1 , Ferda Erkifli 1, Tolga Kaplan 2
1 Bursa Medical Park Hospital Physical Medicine and Rehabilitation Department, Bursa
1 Bursa Medical Park Hospital Orthopedic and Traumatology Department, Bursa
OBJECTIVE: The aim of the study was to determine demographic and clinical features of the
patients with complex regional pain syndrome (CRPS) and to share information.
MATERIALS-METHODS: CPRS diagnosed 75 patients between the years 2008 and 2010
were analyzed retrospectively for clinical and demographic features, accessing data of the
hospital automation data service.
RESULTS: Forty nine percent of total 75 patients were female (F/M: 37/38). The mean age
was 48,6±4,8 years. When etiology was evaluated; 69 patients had a bone fracture, 3
patients had tendon injury operation, 1 patient had a cerebrovascular accident, 1 patient had
soft tissue trauma and 1 patient had carpal tunnel syndrome operation. Five of the patients
with fracture had traffic accident histories and 3 of the patients with fracture had industrial
injury histories. All of the patients had pain and edema in physical examination. Allodynia
range was 12%. Sixteen patients had osteoporosis (21%). Fifty two percent of the fractures
were in lower extremity and ankle was the most of common site with 24 patients and then 6
tibia, 4 foot and 1 patella and 1 femur fractures were detected. The most common fracture in
the upper extremity was the colles fracture with 82% and then humerus fracture with 12%
and forearm fracture with 3%. The mean splinting time was 44.2±9.1 days. Physical medicine
and rehabilitation program offered to all patients but turn out range was 52%. The mean
duration of therapy was 16.2±6.9 days. After the physical medicine and rehabilitation program
61% of patients had no pain, edema and limited range of motion.
CONCLUSION: Our findings of clinical and demographic features of CPRS patients were similar
to previous studies. But fracture is a more common etiology in our study.
Keywords: CRPS, rehabilitation, fracture