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Öğe Atlanto-odontoid osteoarthritis in rheumatoid arthritis: dynamic CT findings(Springer, 2004) Baysal, O; Baysal, T; Sigirci, A; Ersoy, Y; Altay, ZWe analyzed the CT appearances of degenerative change in the atlanto-odontoid joint (AOJ) in patients with rheumatoid arthritis (RA) and evaluated the effect of these changes on atlanto-axial joint (AAJ) rotation by dynamic CT. This revealed that 9 patients (24%) treated with methotrexate had degenerative features in the AOJ. The ratio of AAJ rotation to the total rotation of the cervical spine was significantly higher in normal subjects (54+/-3%) than in patients (38+/-12%). The degree of AAJ rotation was significantly lower in the patient group with degenerative features in the AOJ (20.9+/-8.4degrees) than in patients without degenerative features (28.5+/-7.4degrees). RA patients with a history of longstanding disease and treatment with antirheumatic drugs may develop AO OA. Although secondary OA was described as healing phenomena in the joints of RA patients, it can limit rotation in the AAJ and cause suboccipital neck pain. A regular check-up of the AAJ and AOJ by means of dynamic CT in all RA patients is proposed to avoid possible antirheumatic drug complications.Öğe A case of rhabdomyolysis accompanying acute renal failure secondary to weight lifting(Dustri-Verlag Dr Karl Feistle, 2003) Baysal, O; Taskapan, H; Taskapan, C; Kaya, E; Sahin, I; Kirimlioglu, H; Karakas, N[Abstract Not Available]Öğe Cervical myositis ossificans traumatica: a rare location(Springer Verlag, 1999) Baysal, T; Baysal, O; Sarac, K; Elmali, N; Kutlu, R; Ersoy, YAn unusual case of myositis:ossificans traumatica lesion located in the paraspinal region is reported. Despite the contiguity of the lesion with the cervical vertebrae and ominous appearance of the biopsy material, the history of antecedent trauma and computed tomography findings allowed preoperative accurate diagnosis. To our knowledge, myositis ossificans traumatica located in the cervical paraspinal region is very rare.Öğe Comparison of MRI graded cartilage and MRI based volume measurement in knee osteoarthritis(E M H Swiss Medical Publishers Ltd, 2004) Baysal, O; Baysal, T; Alkan, A; Altay, Z; Yologlu, SObjectives: The aim of this study was to investigate the relationship between the femoral, tibial and patellar cartilage volume and MRI grading of the articular cartilage in patients with knee OA. Methods: Articular cartilage volumes of 65 postmenopausal women were determined by processing images acquired in the sagittal plane using a fast spin echo proton density-weighted sequence. The articular cartilages were divided into 5 compartments including lateral and medial tibial, lateral and medial femoral and patellar compartments. The articular cartilages were graded using a modified Outerbridge classification. Grade 0 indicated intact cartilage, grade 1 chondral softening with normal contour, grade 2 superficial fraying, grade 3 surface irregularity and thinning and grade 4 full thickness cartilage loss. The grades of articular cartilage were compared with cartilage volume measurements. Results: In medial femoral cartilage, grade 1 had more volume compared to grade 0 cartilage (p: 0.017). In medial tibial cartilage, grade I had more volume compared to grade 0 and grade 2 cartilage (p: 0.045 and p: 0.027, respectively). In patellar cartilage, grade I cartilage had significantly more volume than grade 0 cartilage (p: 0.007). In lateral tibial and femoral cartilages, no significant difference was observed between grade 0 and grade 1 cartilage. Conclusions: Cartilage volume correlates well with MR grading of articular cartilage. The higher the grade of the cartilage the less the volume, with the exception of grade 1 lesions. Grade 1, reflects oedema in the cartilage and has a conflicting effect on volume measurement. The combination of MRI based volume measurement and grading of articular cartilage may provide an accurate method for the non-invasive evaluation and follow-up of articular cartilage.Öğe The Crowned Dens syndrome: a rare form of calcium pyrophosphate deposition disease(Springer Verlag, 2000) Baysal, T; Baysal, O; Kutlu, R; Karaman, I; Mizrak, BThe crowned dens syndrome has been termed as acute neck pain ascribed to CPPD deposits associated with a tomographic appearance of calcification surrounding the odontoid process. This rare entity resulting in cervical cord compression is generally seen in older female patients. We present a 26-year-old woman with cervical cord compression due to massive calcification in the periodontoid area and discuss the X-ray and CT findings of the disease.Öğe Diffusion-weighted imaging in chronic Behcet patients with and without neurological findings(Springer, 2005) Baysal, T; Dogan, M; Karlidag, R; Ozisik, HI; Baysal, O; Bulut, T; Sarac, KOur aim was to investigate whether neurological impairment in chronic Behcet's disease (BD) patients with normal appearing brain can be assessed by means of diffusion-weighted imaging (DWI). The averaged apparent diffusion coefficient (ADC) values were calculated in 22 different radiologically normal appearing brain regions in 32 patients with and without neurological findings and 20 control subjects. The ADC values in bilateral frontal, temporal and occipital normal appearing white matter were significantly higher in the patient groups compared with the control subjects (p < 0.05). In these brain regions, DWI revealed differences in the ADC values between patients with neurological findings (including symptomatic and neuro-Behcet patients) and the asymptomatic patient group. The similarity of the ADC values of patients without symptoms to those of the control group allowed clear discrimination between patients with and without neurological findings. DWI may serve to assess subclinical neurological involvement in BD, even when structural changes are absent.Öğe Proton MRS in Behcet's disease with and without neurological findings(Springer, 2003) Baysal, T; Ozisik, HI; Karlidag, R; Sarac, K; Baysal, O; Dusak, A; Hazneci, EOur aim was to investigate whether neurological impairment in Behcet's disease (BD) can be assessed by means of proton MRS and whether it can assist in prognosis. We used single-voxel MRS to measure metabolites in regions of normal-appearing pons, basal ganglia and periventricular white matter (PWM) in 32 patients with chronic BD patients with and without neurological deficits and 29 control subjects. Patients had significantly higher N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios in the basal ganglia than the controls. The Cho/Cr ratio in the PWM was also significantly higher in the patients. MRS enabled clear discrimination of patients and controls and also revealed spectral differences between non-neuro-Behcet's disease and neuro-Behcet's disease in the basal ganglia. MRS can be used to assess brain involvement in BD even if structural changes are absent.Öğe Sonographic evaluation of the carpal tunnel after provocative exercises(Amer Inst Ultrasound Medicine, 2004) Altinok, MT; Baysal, O; Karakas, HM; Firat, AKObjective. Dynamic carpal tunnel syndrome (CTS) is a subtype of CTS in which symptoms usually subside with rest and return with repetitive motions. In this subgroup, nerve conduction studies, performed at rest, are often inconclusive. In this study, the diagnostic value of provocative sonography was evaluated in patients with dynamic CTS. Methods. Twenty wrists of 13 patients with dynamic CTS and 10 control subjects were investigated with sonography before and immediately after provocative exercises imitating work-related stresses. In addition to conventional indices (palmar displacement, nerve area at the middle level, and swelling ratio before and after exercise), 2 newly formed indices (provocative nerve area ratio and provocative palmar displacement ratio) were investigated. Results. In the pre-exercise period, there were no significant differences between patients and control subjects regarding palmar displacement and the swelling ratio. The difference was significant (P = .035) for the nerve area at the middle level. In the post-exercise period, all parameters were significantly different between patients and control subjects. The nerve area at the middle level and the swelling ratio had higher significance (P < .0001) than palmar displacement (P = .015). The post-exercise swelling ratio had the highest sensitivity (95%) in diagnosing dynamic CTS when a cutoff value of 1.26 was used. The provocative palmar displacement ratio had high sensitivity (80%) and the highest specificity (90%) for a cutoff value of 1.28. Conclusions. Provocative exercises increase sensitivity and specificity and contribute to the sonographic diagnosis of dynamic CTS. This examination should be performed if electrodiagnostic test results are negative.Öğe The stone man: myositis (fibrodysplasia) ossificans progressiva(Springer Verlag, 1998) Baysal, T; Elmali, N; Kutlu, R; Baysal, OMyositis ossificans progressiva (MOP) is a rare hereditary connective tissue disorder characterized by progressive ossification of striated muscle and connective tissue associated with pain and disability. It is presumably transmitted as an autosomal dominant defect. Congenital anomalies of the hands and feet are early signs of this disease. Involvement of the spine, hips and extremities lead to the development of the stone man with only less than 600 cases reported in the literature. We present a case of MOP with typical muscle ossifications and skeletal malformations.Öğe Ultrasonographic assessment of mild and moderate idiopathic carpal tunnel syndrome(W B Saunders Co Ltd, 2004) Altinok, T; Baysal, O; Karakas, HM; Sigirci, A; Alkan, A; Kayhan, A; Yologlu, SAIM: To investigate the diagnostic value of uttrasonography in mild and moderate idiopathic carpal tunnel syndrome (CTS). MATERIALS AND METHODS: Cross-sectional areas (CSA), flattening ratios at three different levels, swelling ratio, and palmar displacement were analysed in 26 patients (14 with bilateral and 12 with unilateral disease, 40 wrists in total) for the presence and the severity of CTS. Twenty had normal nerve conduction studies (NCS) defined as mild, and 20 of them had abnormal NCS defined as moderate. The control group consisted of 20 healthy participants. RESULTS: All parameters were significantly different between patient and control groups. Palmar displacement, swelling ratio, CSA at all levels and distal flattening ratio had the highest significance (p < 0.0001). The criterion with the highest sensitivity was the swelling ratio greater than or equal to 1.3 (72.5%), followed by the middle CSA >9 mm(2) and the palmar displacement >2.5 mm. All of these criteria had a higher sensitivity in diagnosing moderate cases (85-100%) than diagnosing mild cases (30-55%). There was a significant difference between normal and mild CTS groups regarding palmar displacement, distal flattening ratio, middle CSA and swelling ratio (p < 0.0001 for all) and between normal and moderate groups regarding all parameters (p < 0.01 - 0.0001). When combined middle CSA, palmar displacement and swelling ratio had an overall discriminatory accuracy of 83.8%. CONCLUSION: Additional diagnostic confirmation can be provided by ukrasonography and may be preferred as the initial step instead of etectrophysiotogical. studies. Detection of at least two of the three criteria (median nerve CSA >9 mm(2) at pisiform Level, swelling ratio 1.3, and palmar displacement >2.5 mm) may be helpful for the verification of the diagnosis. (C) 2004 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.
