Publications by authors named "Rana Terlemez"

14 Publications

  • Page 1 of 1

Transient Osteoporosis of the Hip: A Case Report.

Sisli Etfal Hastan Tip Bul 2020 11;54(4):505-507. Epub 2020 Dec 11.

Department of Physical Medicine and Rehabilitation, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey.

Transient osteoporosis of the hip, idiopathic, is a table, beginning with hip pain without a history of trauma, usually self-limiting and seen in middle-aged men and pregnant women. In this case report, a male patient who was admitted because of hip pain and detected transient osteoporosis go the hip was discussed. The purpose of the case presentation is to emphasize the necessity of transient osteoporosis of the hip in the differential diagnosis of sudden onset of hip pain and to review the literature on this subject.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14744/SEMB.2019.26879DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7751251PMC
December 2020

Relationship between ultrasonographic hand muscle thickness measurements and muscle strength following median or ulnar nerve reconstruction.

Muscle Nerve 2021 03 22;63(3):351-356. Epub 2020 Dec 22.

Department of Physical Medicine and Rehabilitation, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey.

Introduction: The aim of this study was to assess the relationship between ultrasonographic hand muscle thickness measurements and hand muscle strength in patients who underwent median or ulnar nerve reconstruction.

Methods: In this prospective, cross-sectional study, intrinsic hand muscle thicknesses were measured using ultrasound with a 4- to 13-MHz linear-array probe. Measurements of hand strength were performed using a dynamometer and a pinchmeter.

Results: In the median nerve group (n = 11), a moderate correlation (r = 0.694; P = .018) was observed between lateral pinch strength and transverse thenar thickness. In the ulnar nerve group (n = 11), longitudinal thenar thickness below the flexor pollicis longus tendon was moderate to highly correlated with pinch and handgrip strengths (r = 0.726-0.893; P < .05); whole transverse thenar thickness was moderate to highly correlated with pinch strengths (r = 0.724-0.836; P < .05).

Discussion: Sonographic measurements of intrinsic hand muscle thickness may be a useful tool for the assessment and follow-up of patients with median or ulnar nerve injury.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/mus.27129DOI Listing
March 2021

Atypical femoral neck stress fracture in a human immunodeficiency virus-infected patient despite anti-osteoporotic treatment: A case report.

Turk J Phys Med Rehabil 2020 Sep 18;66(3):364-367. Epub 2020 Aug 18.

Department of Physical Medicine and Rehabilitation, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Both human immunodeficiency virus (HIV) infection and antiretroviral therapy are related to an increased risk of fracture. As a result of the developments in HIV treatment in recent years, life expectancy in HIV-infected patients has increased. Therefore, HIV-related musculoskeletal problems such as osteoporosis and avascular necrosis are more common currently. There are complex mechanisms in HIV-related osteoporosis. The loss of bone mineral density is particularly distinctive in the first months of the therapy. In this report, we present a 54-year-old woman admitted to our clinic with right thigh pain for three months and diagnosed with a femoral neck stress fracture.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5606/tftrd.2020.4286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557631PMC
September 2020

Suprascapular nerve block in hemiplegic shoulder pain: comparison of the effectiveness of placebo, local anesthetic, and corticosteroid injections-a randomized controlled study.

Neurol Sci 2020 Nov 10;41(11):3243-3247. Epub 2020 May 10.

Department of Physical Medicine and Rehabilitation, Saglik Bilimleri University, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.

Background: Shoulder pain is a common complication of hemiplegic patients that can interrupt their rehabilitation program and is associated with poorer outcomes. The usefulness of the suprascapular nerve block. (SSNB) in the stroke population has been suggested, but some concerns still remain.

Objectives: To investigate the effect of SSNB on pain intensity and passive range ofmotion (PROM) in patients with hemiplegic shoulder pain (HSP).

Study Design: A prospective, double blind, randomized controlled trial was conductedin 34 stroke patients with HSP. They were randomly divided into three groups: Localanesthetic (LA) injection into the trapezius muscle (placebo group), LA injection into thesuprascapular notch, and LA and corticosteroid (CS) injections into the suprascapularnotch.The main outcome was visual analog scale (VAS) scores evaluated before andafter administration of the injection at 1 hour, 1 week, and 1 month.

Results: There were significant decreases in the VAS scores with all three injections at all follow-up time points (p: 0.001 for the placebo group, p <0.001 for the LA group, and p <0.001 for the LA+CS group). When changes in VAS scores were compared between the groups, the LA+CS group demonstrated a higher decrease in VAS than the placebo group. Improvement in the PROM was seen only in the LA and LA+CS groups.

Conclusions: The findings of this study support the use of an SSNB with or without CS, to increase the range of motion in the affected shoulder, especially during the rehabilitation period.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10072-020-04362-0DOI Listing
November 2020

[Dermatomyositis presenting with low back pain].

Agri 2020 Apr;32(2):99-102

Department of Physical Medicine and Rehabilitation, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

Dermatomyositis (DM) is a rare connective tissue disease characterized by skin lesions and inflammatory changes observed in muscle biopsy findings. A definitive diagnosis of DM requires a characteristic rash in addition to proximal muscle weakness and muscle enzyme level elevation. DM is twice as common in women as men, with an age of onset of approximately 50 years. This case report describes a 29-year-old patient with low back pain and proximal muscle weakness in the legs diagnosed as lumbar disc herniation who was then referred by the neurosurgery department to our clinic. A physical examination revealed the characteristic skin lesions for dermatomyositis. Needle electromyography and a skin biopsy were performed, and corticosteroid treatment was initiated. In misdiagnosed patients, fatty infiltration in the muscles may cause irreversible weakness and gait disturbance. Early suppression of inflammation is important and can yield a dramatic response to treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5505/agri.2018.45578DOI Listing
April 2020

Effect of piriformis injection on neuropathic pain.

Agri 2019 Nov;31(4):178-182

Department of Algology, Health Sciences University, Şişli Hamidiye Etfal Hospital, Health Research and Application Center, İstanbul, Turkey.

Objectives: The aim of this study was to investigate the effect of a piriformis injection on neuropathic pain in patients with piriformis syndrome.

Methods: Thirty patients with unilateral hip and/or leg pain, a positive FAIR test (increased H-reflex latency with Flexion, Adduction and Internal Rotation), and a trigger point at the piriformis muscle were enrolled in this prospective study. All of the patients exhibited neuropathic pain scored according to the Douleur Neuropathique 4 (DN4) of ≥4 for at least 6 months. All of the patients received 4 mL of lidocaine 2%+1 mL of betamethazone to the piriformis muscle under the guidance of ultrasound. The Numeric Rating Scale (NRS), DN4, and the painDETECT (PD) questionnaire were used for outcome assessment.

Results: A statistically significant improvement was seen in all scores (p<0.001) when both first week and first month results were compared with the baseline values. Comparison of the first week results with those of the first month revealed a statistically significant improvement in only the NRS and PD scores (p<0.001). The greatest improvement in all scores was seen in the first week after the injection. A mild increase was seen in all scores at the first month compared to the first week.

Conclusion: A piriformis injection was found to be effective for both somatic and neuropathic pain in piriformis syndrome patients. Long-term follow-up is needed in order to consider this option alongside other treatment alternatives, like botulinum toxin and myofascial release.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14744/agri.2019.34735DOI Listing
November 2019

Coccydynia in a Patient With Ankylosing Spondylitis: Enthesitis or Structural Disorder?

Authors:
Rana Terlemez

Am J Phys Med Rehabil 2019 08;98(8):e101

From the Department of Physical Medicine and Rehabilitation, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PHM.0000000000001119DOI Listing
August 2019

[A rare cause of forearm pain: Schwannoma of the posterior interosseous nerve].

Agri 2018 Apr;30(2):99-101

Department of Physical Therapy and Rehabilitation, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

A schwannoma, also known as a neurilemoma, is composed of Schwann cells, and is the most common benign tumor of the peripheral nerves. It commonly appears as a solitary lesion in the head and neck region. The diagnosis is based on ultrasonography, magnetic resonance imaging, and histopathological examination. This encapsulated tumor has a good prognosis with a low recurrence rate after surgical removal. This case report is a description of a forearm schwannoma that initially appeared to be a ganglion cyst.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5505/agri.2016.04127DOI Listing
April 2018

The Effect of Associated Parkinsonism on Rehabilitation in Stroke Patients: A Case Series.

Sisli Etfal Hastan Tip Bul 2018 29;52(1):64-69. Epub 2018 Mar 29.

Department of Physical Therapy and Rehabilitation, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

Stroke and Parkinson's disease are 2 major causes of movement impairment and a decreased ability to perform daily activities. The aim of this case series was to demonstrate the difficulty of rehabilitation in stroke patients with accompanying parkinsonism. Four stroke patients with parkinsonism who underwent rehabilitation at the Physical Medicine and Rehabilitation Clinic between March and May of 2016 were evaluated. The Standardized Mini-Mental State Examination (SMMSE), the Functional Independence Measure (FIM), the Barthel Index (BI), the Berg Balance Scale (BBS), and the Stroke Impact Scale version 3.0 (SIS) were used in the assessment. Of the 4 patients, 3 were female, and the mean age was 74.5±9.3 years. The mean hospital stay was 19±5.3 days. The initial test scores recorded were low, and they remained low at the time of discharge. After rehabilitation, the mean FIM score in the group was 42% of the maximum possible score, the mean SMMSE was 55%, the BI was 18%, the BBS was 0.08%, and the SIS was 25%. Three patients required a wheelchair, and 1 patient could ambulate with a walker at discharge. A stroke accompanied by parkinsonism negatively affects mobility and functional status, primarily through the deterioration of balance. In this study, cognitive function was reduced to half of the maximum, and the balance and function loss was more than 50%. Barthel index; berg balance scale; functional independence measure; mini-mental state examination; parkinsonism; stroke; stroke impact scale.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14744/SEMB.2017.69772DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315070PMC
March 2018

A rare cause of thigh pain: Morel-lavallée lesion.

Turk J Phys Med Rehabil 2018 Mar 5;64(1):80-82. Epub 2018 Feb 5.

Department of Physical Medicine and Rehabilitation, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

Morel-Lavallée lesion is an unusual clinical entity which was first described by the French surgeon Maurice Morel-Lavallée in 1853. These lesions result from peeling off the surfaces between the fat tissue and the muscular fascia. During this decomposition, the rupture of small vessels may cause an effusion full of necrotic blood, lymph and fat cells. In prolonged cases, these lesions may become increasingly painful, leading to be confused with other diagnosis such as sciatalgia, piriformis syndrome, trochanteric bursitis or soft tissue tumor. Herein, we present a-65-year-old female case who had pain in the right thigh for one year and was referred to our clinic with radicular pain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5606/tftrd.2018.1184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709606PMC
March 2018

Comparison of Ultrasonography and Short-Segment Nerve Conduction Study in Ulnar Neuropathy at the Elbow.

Arch Phys Med Rehabil 2018 01 5;99(1):116-120. Epub 2017 Oct 5.

Department of Physical Therapy and Rehabilitation, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Istanbul, Turkey.

Objective: To assess the correlation between ultrasonographic and electrodiagnostic findings to determine the localization of the ulnar trapping at the elbow.

Design: Cross-sectional and noninterventional trial.

Setting: Physical medicine and rehabilitation department of a teaching hospital.

Participants: Patients (N=14) diagnosed with ulnar nerve entrapment using short-segment nerve conduction study.

Interventions: The elbow area was divided into 4 segments with 2-cm intervals. All patients underwent ultrasonographic and electrodiagnostic examinations.

Main Outcome Measures: The nerve conduction velocity (NCV) of each segment was measured. The cross-sectional area (CSA) of the ulnar nerve was measured at 5 levels. The proximal CSA/distal CSA ratio (PDR) was calculated by proportioning the CSA values for each segment. The highest PDR was accepted as a trapping segment, whereas the segment with the lowest NCV was accepted electrophysiologically (provided it was <50m/s).

Results: A total of 80 PDR and NCV measurements were taken from 20 elbows. A statistically significant negative correlation (r=-.554; P<.001) was found between general PDR and NCV values. When we assumed that the NCV value <50m/s as the criterion standard for diagnosis, the cutoff value for the PDR was found to be 1.08, with a sensitivity of 70% and a specificity of 92.5%. The minimum NCV value and the maximum PDR value were mostly seen in the third segment compatible with the cubital tunnel.

Conclusions: Ultrasonography seems to be advantageous because it is more comfortable for the patient and requires shorter time than does electroneuromyography. To our knowledge, this is the first study to detect ulnar nerve entrapment by using not only CSA but also PDR as a ratio method with ultrasound.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.apmr.2017.09.111DOI Listing
January 2018

The clinical importance of the thyroid nodules during anti-tumor necrosis factor therapy in patients with axial spondyloarthritis.

Clin Rheumatol 2017 May 30;36(5):1071-1076. Epub 2017 Mar 30.

Cerrahpasa Medical Faculty, Physical Medicine and Rehabilitation, Rheumatology, Istanbul University, Istanbul, Turkey.

The clinical importance of the thyroid nodules in patients with axial spondyloarthritis (ax-SpA) rests with the need to exclude thyroid malignancy. The aim of this study is to assess the risk of thyroid malignancy in ax-SpA patients receiving anti-TNF therapy. From September 2015 until December 2015, 70 patients diagnosed with ax-SpA were included in the research. Forty of the patients had received anti-TNF therapy, and 30 of the patients were anti-TNF naive. All cases were screened for the presence of nodules in the thyroid gland with ultrasound. Of the patients that received anti-TNF therapy, 15 (37.5%); and of the anti-TNF naive patients, 11 (36.7%) had thyroid nodule(s). Four patients from the anti-TNF group underwent fine needle aspiration biopsy of the nodules, and two of them were diagnosed with papillary thyroid carcinoma. None of the nodules in anti-TNF naive patients required biopsy. When compared to the normal population, the standardized incidence ratio (SIR) was found to be increased in both male (SIR 2.03, 95% CI 1.9 to 18) and female (SIR 2.7, 95% CI 2.6 to 24) cases. It is not yet established whether the development of cancer during the treatment process is the effect of the treatment or if it is a part of the natural course of the disease or if it is coincidental. We saw a mild increase in thyroid malignancies in ax-SpA patients who received anti-TNF therapy. Therefore, we believe that the thyroid gland should also be taken into consideration while screening for malignancy before anti-TNF therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10067-017-3607-8DOI Listing
May 2017

Ultrasound-Guided Diagnosis and Injection of the Lateral Femoral Cutaneous Nerve with an Anatomical Variation.

Pain Pract 2017 11 25;17(8):1105-1108. Epub 2017 Feb 25.

Department of Physical Medicine and Rehabilitation, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

Meralgia paresthetica (MP) is an entrapment neuropathy of the lateral femoral cutaneous nerve (LFCN). There are many variations in the course of the LFCN. A 55-year-old woman presented with pain and tingling sensations on the anterolateral aspect of her left thigh. Physical examination revealed hypoesthesia of the proximal anterolateral thigh on the left side. During the electrodiagnostic study, sensory nerve action potential of the LFCN could not be obtained on both sides. Through those clinical and electrophysiological findings, we prediagnosed the case as MP and planned to perform diagnostic nerve block. For the injection to perform, ultrasonography was used. During the ultrasonographic evaluation, the left LFCN was visualized lateral to the anterior superior iliac spine (ASIS). Then ultrasound-guided nerve block with 2 cc lidocaine 2% for diagnostic purpose was performed in this region. Immediately after the injection, the patient's complaints relieved completely, and hence the patient was diagnosed as having MP with an LFCN anatomical variation. Two months later her complaints persisted, and ultrasound-guided LFCN injection with 2 mL of lidocaine 2% + 1 cc of betametazone was performed. One month after the second injection, her complaints were relieved markedly and she resumed her daily activities. In conclusion, the course of the LFCN is quite variable. We present a relatively rare anatomical variation of the LFCN, crossing lateral to the ASIS, diagnosed with ultrasonography. Ultrasonography can be performed to visualize the LFCN, especially a nerve with an anatomical variation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/papr.12559DOI Listing
November 2017
-->