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Öğe Ankilozan spondilit tanılı hastalarda nöropatik ağrı bileşeni, sinir iletim çalışması bulguları ve nöropatik ağrı bileşeninin hastalık parametreleri ile ilişkisi(Sivas Cumhuriyet Üniversitesi, 2020) Atik, Seda; Şahin, ÖzlemSon zamanlarda romatolojik hastalıklarda nöropatik ağrı sıklığının arttığı bildirilmiştir. Bizde çalışmamızda Ankilozan Spondilit (AS) hastalarında nöropatik ağrı bileşenini, bu hastalarda sinir iletim çalışması bulgularını ve nöropatik ağrının hastalık parametreleri üzerindeki etkisini ortaya koyabilmeyi amaçladık. Çalışmaya 40 AS'li hasta dahil edildi. Çalışmaya katılan hastaların 21'i kadın, 19'u erkekti. Çalışmaya dahil edilen kişilerin HLA-B27 durumu, B12 ve D vitamini düzeyi, C-Reaktif Protein (CRP), Eritrosit Sedimentasyon Hızı (ESH) değerleri kaydedildi. Tüm katılımcıların hastalık aktivitesinin değerlendirilmesinde Bath AS Hastalık Aktivite İndeksi (BASDAI) ve AS Hastalık Aktivite Skoru (ASDAS)-CRP/ESH indeksleri kullanıldı. Fonksiyonel durumlarını tespit etmek için Bath AS Fonksiyonel indeksi (BASFI) kullanıldı. Fizik muayene bulgularına göre Maastricht Ankilozan Spondilit Entezit Skoru (MASES) ve Bath Ankilozan Spondilit Metroloji İndeksi (BASMI) skorları belirlendi. Tüm katılımcılara nöropatik ağrı varlığını belirleyebilmek için Pain Detect, LANSS, DN4 anketleri yapıldı. Elektrofizyolojik olarak tüm hastalarda bilateral median ve ulnar sinir motor ve duyu, tibial ve peroneal sinir motor, bilateral sural sinir duyu iletim çalışmaları yapıldı. Hastaların yaş ortalaması 42.17'di. Hastalar Pain Detect, LANSS, DN4 anket sonuçlarına göre nöropatik ağrısı olan ve olmayan olarak iki gruba ayrıldı. Pain Detect anket sonuçlarına göre nöropatik ağrısı olan grupta ASQoL (p<0.05), BASDAI (p<0.05), ASDAS-ESH (p<0.05) parametreleri istatistiksel olarak anlamlı düzeyde yüksek bulundu. MASES, BASMI, BASFI, ASDAS-CRP değerleride nöropatik ağrı olan grupta yüksek saptandı. Ancak gruplar arasında istatistiksel olarak anlamlı bir fark yoktu. LANSS ve DN4 anket sonuçlarına göre de nöropatik ağrı saptanan grupta MASES, ASQoL, BASDAI, BASFI, ASDAS-ESH değerleri istatistiksel olarak anlamlı düzeyde yüksekti. Pain Detect anketine göre nöropatik ağrı saptanan 23 hastanın 8'inde, LANSS ve DN4'e göre nöropatik ağrı saptanan 17 hastanın 6'sında elektrofizyolojik anormalliğe rastlandı. Aksiyel tutulumu olan hastaların %16.7'sinde, periferik ve aksiyel tutuluma sahip hastaların ise %40'ında elektrofizyolojik anormallik saptanmıştır. Sonuç olarak bu çalışmada AS'li hastaların büyük bir oranında nöropatik ağrı komponentininde olabileceğini tespit ettik. Bu ağrının hastaların yaşam kalitesini kötü yönde etkilediğini ve yüksek hastalık aktivite skorlarıyla ilişkili olduğunu bulduk. Ankilozan spondilitli hastalarda periferik nöropatiye de yatkınlık oluşabileceğini düşündük. Bu hastalarda nöropatik şikayetlerin ayrıntılı sorgulanmasının ve gerekirse tedavi edilmesinin hastaların yaşam kalitesine olumlu yönde katkı yapacağı ve bir kısmı çok da objektif olarak değerlendirilemeyen hastalık aktivite ölçeklerinin düzeylerinde azalma görülerek aşırı anti-inflamatuvar tedavinin de engellenebileceği kanaatindeyiz.Öğe Contribution of Lumbar Vertebral Magnetic Resonance Imaging to Diagnosis in Women with Osteoporosis(Galenos Publ House, 2022) Atik, Irfan; Atik, Seda; Gul, Enes; Bulut, SemaObjective: The aims of this study are to compare bone mineral densitometry and magnetic resonance imaging (MRI) findings in postmenopausal women diagnosed with osteoporosis and the investigation of the effectiveness of MRI in the diagnosis of osteoporosis. Materials and Methods: Forty female patients, 50 years of age or older who underwent lumbar MRI examination and were diagnosed with dual-energy X-ray absorptiometry (DEXA) osteoporosis were included in our study. Forty healthy women aged 20-29 years with lumbar MRI examinations were included in the control group. On sagittal T1-weighted (T1W) images of individuals in the patient and control groups signalto-noise ratio (SNR) was measured from L1-L4 vertebrae. To facilitate the diagnosis of osteoporosis, a quantitative score called the M-score was obtained using SNR values. The relationship between DEXA and the obtained SNR and M-score values were investigated. Results: In the patient group, median SNR values of L1, L2, L3, L4 vertebrae obtained from T1-weighted sequence was 57.49 (25.18-182.48), and they were 24.90 (7.40-41.70) in the control group. Receiver operating characteristics analysis was performed for L1, L2, L3, L4 vertebrae. The area under the curve for the mean value of L1-L4 vertebra was found to be 0.966 (p < 0.001), and the 95% confidence interval was found 0.933-1.000. The mean SNR predictive value of L1-L4 was calculated as 33.45, and sensitivity for this value was found to be 90%, and specificity was found to be 90%. There was a negative correlation between lumbar MRI SNR-DEXA (p > 0.05) and M score-DEXA (p > 0.05). Conclusion: It has been concluded that L1-L4 vertebral SNR measurement in T1-weighted sequence in lumbar MRI can be used to distinguish osteoporosis patients from normal individuals. Thus, osteoporosis can be diagnosed without X-ray exposure.Öğe Diagnostic Contribution of Hematological Parameters in Patients with Lung İnvolvement in Rheumatoid Arthritis(Sivas Cumhuriyet Üniversitesi, 2024) Atik, Seda; Apalan, Deniz; Atik, İrfanRheumatoid arthritis (RA) is a prevalent autoimmune condition, with lung involvement being its most frequent extra-articular manifestation. Our study aims to investigate the contribution of hematological parameters to diagnosing lung involvement in patients with RA. Individuals with RA were divided into two groups according to lung involvement in thorax computed tomography. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophil, lymphocyte, monocyte, platelet, neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR) and systemic immune-inflammatory index (SII) were evaluated in all patients. Twenty-nine of the seventy-five RA patients were found to have lung involvement, and lung involvement was not observed in forty-six patients. CRP, ESR, and neutrophils were high in patients with lung involvement and a statistically notable distinction was observed. Lymphocyte count was low in patients with lung involvement and was statistically significant. NLR, NMO, and SII rates were high in patients with lung involvement and were statistically significant. It is observed that hematological parameters contribute to diagnosing RA lung involvement.Öğe Diagnostic value of Achilles tendon shear wave elastography in patients with ankylosing spondylitis: A case-control study(Wiley, 2024) Atik, Irfan; Atik, Seda; Gul, EnesObjectives: Ankylosing spondylitis (AS) can cause peripheral arthritis, tendinitis, enthesitis, and axial skeletal involvement. This study aims to determine early tendon damage by shear wave elastography (SWE) for the Achilles tendon in AS patients. Methods: 48 AS patients and 48 asymptomatic individuals were included in the study. Participants were systematically examined with B-mode, power Doppler, and SWE using a high-resolution linear 6-15 MHz probe. Bilateral Achilles tendon stiffness, thickness, and vascularity were evaluated. Measurements were taken from the middle third of the Achilles tendon in the sagittal plane. Difference between the two groups was evaluated with statistical methods. Receiver operating characteristic analysis was performed to test the diagnostic performance of Achilles tendon stiffness. Additionally, the Spearman correlation test examined the relationship between Achilles tendon stiffness and disease duration. Results: The difference between the two groups regarding Achilles tendon stiffness was statistically significant (p < 0.05). It was observed that Achilles tendon stiffness decreased in the patient group compared with the control group. The diagnostic value of Achilles tendon stiffness measured by SWE was found to be high. A negative correlation was detected between disease duration and tendon stiffness (p < 0.05). Conclusion: In patients diagnosed with AS, deterioration in the Achilles tendon structure was observed, and a significant decrease in tendon stiffness compared with the healthy population. It has been determined that these changes in the Achilles tendon are related to the duration of the disease.Öğe Effectiveness of shear wave elastography for assessing major salivary gland involvement in ankylosing spondylitis(Colegio Brasileiro de Radiologia, 2025) Atik, Irfan; Atik, Seda; Gul, EnesObjective: To use shear wave elastography (SWE) in the evaluation of salivary glands in patients with ankylosing spondylitis (AS) who present with sicca symptoms. Materials and Methods: This was a prospective controlled study of patients diagnosed with AS and exhibiting sicca symptoms (study group) and of healthy volunteers (control group). The levels of antinuclear, anti-Ro, and anti-La antibodies were determined in blood samples. In both groups, parotid and submandibular glands were evaluated by ultrasound and tissue stiffness was determined by SWE. Intraclass correlation coefficients were used in order to assess reliability. The differences between the two groups were assessed by statistical methods, and a ROC curve analysis was performed to determine the predictive values. Results: A total of 66 patients with AS and 71 healthy volunteers were included in the study. There were no significant differences between the groups in terms of age or sex (p > 0.05). The intra-and inter-rater reliability of SWE were good for the parotid gland (0.81–0.85 and 0.80, respectively) and for the submandibular gland (0.85–0.88 and 0.80, respectively). Statistically significant differences were found. Tissue stiffness in the parotid and submandibular glands, as determined by SWE, was significantly greater in the study group than in the control group (p < 0.05). Conclusion: Although there was no histopathological correlation in the parotid and submandibular salivary glands of patients with AS and sicca symptoms compared with the healthy volunteers, quantitative measurements showed greater tissue stiffness in the former group. In patients with AS, SWE guides salivary gland biopsy, which is the gold standard for diagnosing Sjögren’s syndrome. © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem.Öğe Evaluation of Subclinical Atherosclerosis in Patients with Psoriatic Arthritis(2024) Atik, Irfan; Atik, Seda; Gul, EnesBackground/Aims: Psoriatic arthritis with peripheral and axial involvement; It is a heterogeneous disease that can cause enthesitis, dactylitis, and nail and skin involvement. The persistence of inflammation in psoriasis leads to comorbidities such as psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Our study aimed to identify subclinical atherosclerosis in psoriatic arthritis patients without a known risk factor and to prevent possible morbidity and mortality in patients. Methods: Thirty-three patients with psoriatic arthritis and twenty-five healthy control groups were included in our study. Diabetes mellitus, hypertension, coronary artery disease, diagnosis of hyperlipidemia, body mass index above 30, and smoking were determined as exclusion criteria. The age, gender, duration of the disease, medical treatment used for the disease, high-density lipoprotein, low-density lipoprotein, triglyceride, and total cholesterol values, monocyte-lymphocyte ratio, carotid intima-media thickness measurement results obtained by carotid doppler ultrasonography imaging were recorded. Results: A comparison was made between the study and control groups in terms of age, triglyceride, high-density lipoprotein, low-density lipoprotein, and monocyte-lymphocyte ratio, and no statistically significant difference was observed. Monocyte and lymphocyte levels were significantly higher in the study group (p<0.05). Carotid intima-media thickness was statistically higher in the study group and this difference was statistically significant (p<0.05). Conclusions: Patients with psoriatic arthritis have an increased risk of atherosclerosis compared to the healthy population without any risk factors. This awareness will be useful in the follow-up of patients and in taking precautions against morbidities that may develop.Öğe Evaluation of the relationship between Knee Osteoarthritis and Meniscus Pathologies(Malawi Medical Journal, 2024) Atik, Irfan; Gul, Enes; Atik, SedaBackground Knee osteoarthritis is a common, degenerative joint disease that causes chronic pain that affects daily life. Our study aims to evaluate geriatric patients aged 65 and over with knee pain in terms of osteoarthritis with radiography and magnetic resonance imaging and to investigate its relationship with meniscal pathologies. Methods Radiography and magnetic resonance imaging of patients aged 65-88 years with knee pain were evaluated in terms of knee osteoarthritis and staging was performed. Meniscal pathologies were evaluated in magnetic resonance imaging, and the prevalence of different meniscal lesion types was calculated. In addition, the relationship between knee osteoarthritis and meniscal pathologies was analyzed. Results Radiographic evidence of knee osteoarthritis was found in 182 (84.2%) of the 216 cases in our study group. A strong correlation was found between the degrees of knee osteoarthritis on magnetic resonance imaging and radiography. At least one meniscus pathology was observed in all 182 radiography cases with knee osteoarthritis findings. At least one meniscus pathology was observed in 29 (85.3%) of those without osteoarthritis signs. It was determined that meniscus degeneration, tear, and extrusion were observed more frequently in patients with knee osteoarthritis than in patients without osteoarthritis. Meniscal extrusion and complex and horizontal-type tears were the most common lesions. Conclusions Osteoarthritis was found to be common in geriatric patients with knee pain. A correlation was found between radiography and magnetic resonance imaging regarding knee osteoarthritis. It was observed that meniscal pathologies were detected more frequently in patients with knee osteoarthritis. © 2024 Kamuzu University of Health Sciences.Öğe Frequency of Neuropathic Pain in Ankylosing Spondylitis Patients(Sivas Cumhuriyet Üniversitesi, 2024) Atik, Seda; Şahin, ÖzlemAnkylosing Spondylitis(AS) is a common chronic inflammatory rheumatological disease. It is known that neuropathic pain, as well as inflammatory pain, increases in rheumatic diseases. In our study, we aimed to investigate the presence of neuropathic pain in AS patients, which we frequently encounter in clinical practice. 52 AS patients were included in the study. HLA-B27 genetic test results, c-reactive protein, and erythrocyte sedimentation rate values of the people included in the study were recorded. LANSS pain scale was applied to all participants to determine neuropathic pain, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was applied to evaluate disease activity. The average age of the individuals participating in the study was 42.57. According to the results of the LANSS pain scale, neuropathic pain was detected in 24 (46.2%) of the individuals. According to BASDAI results, 61.5% of the patients had active disease. A statistically significant relationship was detected between active disease and neuropathic pain (p = 0.001). It was concluded that neuropathic pain may accompany the clinic in a large proportion of patients with AS. We believe that detailed questioning of neuropathic complaints in these patients and treatment if necessary will contribute positively to the quality of life of the patients, and excessive anti-inflammatory treatment can be prevented by reducing the levels of disease activity scales, some of which cannot be evaluated very objectively.Öğe Neuropathic Pain Component in Patients with Ankylosing Spondylitis and the Relationship of Neuropathic Pain and Disease Activity Parameters: A Cross-Sectional Study(Jmni, 2024) Atik, Seda; Sahin, Ozlem; Atik, Irfan; Polat, MusaObjective: It is known that neuropathic pain frequently accompanies rheumatological diseases. In this study, neuropathic pain in Ankylosing Spondylitis(AS) and its relationship with disease activity were investigated. Methods: Forty patients with AS were included. Laboratory data and disease status parameters were recorded. Neuropathic pain questionnaires were administered. Electrophysiological examination was performed on all patients. The relationship between neuropathic pain and disease activity parameters was investigated. Results: According to the Pain Detect and LANSS questionnaire results, the rate of neuropathic pain was 57.5% and 42.5%. ASQoL, BASDAI, and ASDASESH parameters are statistically significantly higher in the group with neuropathic pain according to the PainDetect (p:0.018, p:0.04, p:0.028). MASES, ASQoL, BASDAI, BASFI, and ASDAS-ESH parameters are statistically significantly higher in the group with neuropathic pain according to the LANSS (p:0.004, p:0.005, p: 0.001, p:0.005, p:0.02). Disease activity is higher in patients with neuropathic pain for both scales. Peripheral neuropathy is detected in nine patients. There is a positive correlation between disease activity parameters and neuropathic pain scales. A strong positive correlation was detected between ASQoL and BASDAI parameters and the Pain Detect questionnaire (r:0.533, r:0.606). Conclusions: The majority of patients with AS have a neuropathic pain. This condition is associated with high disease activity and adversely affects the patient's quality of life.Öğe Relationship between sacroiliitis and inflammatory markers in familial Mediterranean fever(Assoc Medica Brasileira, 2024) Atik, Irfan; Atik, SedaOBJECTIVE: Familial Mediterranean fever is the most common monogenic autoinflammatory disease. This study aimed to evaluate the relationship between sacroiliitis observed in familial Mediterranean fever and hematological inflammatory markers. METHODS: In this study, 168 familial Mediterranean fever patients were examined. A total of 61 familial Mediterranean fever patients who had sacroiliac magnetic resonance imaging due to waist and hip pain were included in the study. According to the magnetic resonance imaging findings, patients were divided into two groups: with and without sacroiliitis. The relationship between hematological inflammatory markers and sacroiliitis was investigated. RESULTS: The frequency of sacroiliitis was found to be 13.6% in all familial Mediterranean fever patients and 37.8% in patients with low back pain who underwent sacroiliac magnetic resonance imaging. Neutrophil count, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, and systemic immuneinflammatory index were significantly higher in the sacroiliitis group than in the other group, and this difference was found to be statistically significant (p<0.05). As a result of the receiver operating characteristic analysis, it was observed that neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, and systemic immune -inflammatory index were very sensitive parameters in determining sacroiliitis in patients with familial Mediterranean fever. CONCLUSION: It was observed that the frequency of sacroiliitis was increased in familial Mediterranean fever patients. It is predicted that hematological inflammatory markers such as neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, and systemic immune -inflammatory index can be used in the diagnosis of sacroiliitis.Öğe Sonographic and magnetic resonance imaging findings in post-traumatic median nerve neuroma: A case report(Wiley, 2024) Atik, Irfan; Apalan, Deniz; Atik, Seda; Gul, EnesNerves are frequently damaged in cases of blunt or penetrating injuries to the limbs. Post-traumatic neuromas arising from peripheral nerves are formations that emerge after nerve injury, potentially leading to swollen and agonizing nerve terminations upon severance. Post-traumatic neuromas commonly appear as irregular, non-cancerous nodules formed due to injury-induced damage. The most common clinical symptom is neuralgic pain significantly the patient's quality of life. The main peripheral nerve abnormalities that lead to a referral for imaging are benign peripheral nerve tumors such as schwannoma, neurofibroma, and traumatic pathologies. This case report discusses a 35-year-old woman who presented with a neuroma in her wrist months after a laceration and trauma, with typical imaging findings on sonographic and magnetic resonance imaging.
