فهرست مطالب anousheh haghighi

Psoriasis is a common, chronic, immune-mediated inflammatory disease with a variety of skin manifestations. The aim of this study was to determine the prevalence of subclinical Achilles tendon disorder in cutaneous psoriasis patients and compare it with healthy controls.

This was a cross-sectional case-control study conducted on psoriasis patients that were referred to dermatology clinic. Thirty patients in the case group and 30 healthy controls were included in the study. Thickness of Achilles tendon enthesis was scanned by an expert rheumatologist using ultrasound equipped with a 5-14 MHz linear prob bilaterally.

The mean age of the patient and control groups was 43.97±16.82 years and 38.87±12.71 years, respectively (P=0.190). The mean thickness of the Achilles tendon enthesis in the dominant limb was 4.31±0.86 mm in the patient group and 4.10±0.54 mm in the control group. There was no significant difference between the two groups in terms of thickness of the Achilles tendon enthesis in the dominant limb (P=0.276). The mean thickness of the Achilles tendon enthesis in the non-dominant limb was 4.44±0.91 mm in the patient group and 4.14±0.59 mm in the control group. There was no significant difference between the two groups in terms of thickness of Achilles tendon enthesis in the non-dominant limb (P = 0.134).

Although ultrasonography may be utilized for assessment of both structural and inflammatory changes, we revealed no difference in the mean thickness of Achilles tendon enthesis in patients with cutaneous psoriasis. Contradiction between clinical and ultrasonography features required further research.

Background &

Raynaud's is a common phenomenon that is also seen in connective tissue diseases such as polymyositis, lupus and mixed connective tissue diseases. However, its occurrence is more pronounced in systemic sclerosis. This phenomenon can be so severe that it leads to cyanosis and gangrene of the fingertips in the final stages. In Raynaud's phenomenon, finger discoloration occurs during contact with cold weather during various stages. First, the skin turns white, then cyanotic and blue, and then changes color to red. The primary pathology in Raynaud's phenomenon is spasm of the end vessels of the limbs and involvement in it from the distal part of the limb and fingers to the proximal, which gradually causes skin atrophy. Capillaroscopy is a method used to diagnose Raynaud's phenomenon and can be used to evaluate the functional and morphological changes of microcirculation in connective tissue diseases (CTDs). Examination of nail capillaries can reveal the nature and extent of microvascular pathology in patients Show CTD. This method can clearly show the main capillary changes of the nail, including megcapillary, capillary bleeding and reduced capillary distribution, in diseases such as systemic sclerosis. The aim of this study was to determine the capillaroscopy findings in CTD patients. After the study, data on Raynaud's patients were compared with other patients. In other words, the aim of this study was to determine the microvascular structure, capillary density, loop diameter, microhemorrhage and angiogenesis in patients and non-patients with Raynaud's syndrome.

The case control study was performed on patients who referred to the rheumatology clinic of Rasoul Akram hospital in Tehran from 2017 to 2019. According to ACR criteria, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, dermatomyositis, polymyositis, Sjogren and mixed connective tissue disease were included in the study. Patients were divided into two groups according to Raynaud's disease and the findings of capillaroscopy were compared. Written consent was obtained from all patients stating their consent to enter the project. Information obtained from patients was considered confidential. The results of the study were performed without publishing the names of the patients.

Finally, 96 people (22 male / 74 female) participated in the final analysis after completing the required data. The mean age of patients was 46.22 ± 14.02 years (18-84 years). In total, out of 96 cases, 30 (31.3%) had normal, 17 (17.7%) had nonspecific morphological abnormality (NSMA) and 49 (51%) had Scleroderma Pattern. There was no statistically significant difference in capillaroscopy findings according to gender and age groups. Abnormalities of microvascular structures and capillary density as well as loop diameters were significantly higher in the scleroderma group than in the other groups. In terms of micro hemorrhage and angiogenesis, most of the positive cases were in the scleroderma. Abnormalities of microvascular structures and loop diameters were significantly higher in the Raynaud than in the non-Raynaud patients.

There was a statistically significant difference between the Capillaroscopy results. This difference in microvascular structures and loop diameters was significant between Raynaud's patients and other patients, so that Raynaud's patients had a higher relative frequency of abnormal microvascular structures and abnormal loop diameters. According to some studies, the trend of capillary changes can be highly related to the progression of the disease to diseases of the scleroderma spectrum. Therefore, it seems that the sequence of using Capillaroscopy can be helpful in diagnosing these changes.

Musculoskeletal problems include motor movement constraints in hemodialysis patients, which affects their quality of life. Ultrasonography is currently used to evaluate superficial tendons and ligaments attached to the joint. The aim of this study was to determine the frequency and Achilles tendon’s changes as an example of tendon involvement in patients with renal failure under regular hemodialysis using ultrasound examination and its related factors.

This case-control study was performed among healthy individuals and patients referred to hemodialysis unit in dialysis unit of Rasoul Akram hospital in a period of one year (from April 2017 to April 2018). The inclusion criteria were end stage renal disease (ESRD) and regular hemodialysis for at least 6 months three times a week and 4 hours each session. Patients were excluded from the study because of systemic inflammatory disease, such as rheumatoid arthritis, systemic lupus erythematosus as the cause of renal failure, previous trauma and bone fracture, TB disease. The control group was selected among healthy volunteers. An ultrasound evaluation was performed using probes with dynamic and linear array scanners with a frequency of 12 MHz.

Thirty patients and 30 healthy subjects were enrolled. In the ultrasonography of the tendon in patients, the median and proximal areas of the right and left Achilles were compared in two groups. The ultrasonic indexes of the different parts of the Achilles tendon were higher in the patients than healthy subjects. Of course, this difference was statistically significant only in the left Achilles proximal area. In general, the elastography of left and right Achilles tendon was lower in the healthy group. There was no correlation between the mean elastography of right and left Achilles tendon with age and PTH in participant groups.

Finally, the findings from the study showed that in the patients’ group, the thickness and area of Achilles tendon and left ventricle were higher than the control group. Also, evaluation of elastography indices showed tenderness of elasticity of tendon in dialysis patients compared to healthy subjects.

Diabetes mellitus (DM) is a common metabolic disease associated with carpal tunnel syndrome (CTS) and tendinopathy. This study aims to assess the ultrasonographic (US) parameters of the flexor tendon and median nerve in asymptomatic subjects with diabetes in comparison with controls without diabetes. 22 DM and 22 non-DM subjects without any symptoms or manipulations in non-dominant hands and wrists were assessed. The ultrasound evaluation of the length, width, cross-sectional area and circumference of forth flexor tendon and the median nerve was performed in the two groups. There was no statistically significant difference of age (P = 0.473) , gender (P = 0.364) , wrist circumferences (P = 0.1921) between the two groups. This study showed no significant difference between the two groups in the median nerve length (P = 0.35), width (P = 0.17), cross-sectional circumference (P = 0.23) and cross-sectional area (P = 0.16). Also, comparing of the sonographic data of the fourth flexor tendon between the two groups presented no significant difference in the length (P = 0.68), width (P = 0.80), cross-sectional circumference (P = 0.70) and cross-sectional area (P = 0.80). In conclusion, our data showed that sonographic values of the median nerve and fourth flexor tendon in asymptomatic subjects with DM did not significantly differ with non-diabetics. These findings demonstrate that still more case studies and more evaluations are required to validate the applicability of ultrasonography in the prediction of carpal tunnel syndrome and tendinopathy in diabetic patients.