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    Effectiveness of USG-guided corticosteroid injection administered into the glenohumeral joint and oral prednisone treatment in patients with adhesive capsulitis
    (2024) Yildirim, Hatice Kubra; Ersoy, Yuksel; Buyukavci, Raikan; Comruk, Emine Burcu
    Aim: This study aims to compare the efficacy of ultrasonography-guided corticosteroid injection to the glenohumeral joint and oral steroid therapy on clinical response and inferior axillary pouch (AR) thickness measured by ultrasonography (USG) in patients with adhesive capsulitis (AC). Materials and Methods: Our prospective randomized study included 48 patients (18-65 years) with a diagnosis of AC. The first group (n=24) underwent USG-guided corticosteroid injection to glenohumeral joint. In the second group (n=24), oral prednisone was started at 0.5 mg/kg dose with the dosing schedule determined by decreasing and continued for 6 weeks. Both groups were also included in a standard physical therapy program (electrotherapy+exercises). The questionnaire, active and passive shoulder joint range of motion (ROM) measurements, Shoulder Pain and Disability Index (SPADI), evaluation of the joint with USG, and AR thickness measurements were performed. Results: There was a statistically significant increase in passive-active ROM values in all directions before and after the treatment (p<0.05) and decrease in AR values after the treatment (p<0.001) in both groups. However, there was no significant difference between the two groups. In addition, the decrease in inferior pouch thickness and the decrease in SPADI scores were positively correlated. Conclusion: Steroid injection into the glenohumeral joint and oral steroid use significantly reduced shoulder pain and disability and increased range of motion in AC patients. Moreover, both oral steroid and steroid injection treatments improved radiologic findings (by reducing AR), consistent with clinical response. Although both treatments were effective, they were not superior to each other.
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    Neuropathic pain in patients with post-COVID-19
    (Kare Publ, 2023) Comruk, Emine Burcu; Buyukavci, Raikan; Comruk, Erol; Akturk, Semra; Ersoy, Yuksel
    OBJECTIVE: In this study, we aimed to determine the continuing pain during the post-COVID-19 period the frequency of neuropathic pain in these patients, and the factors affecting the frequency. METHODS: A total of 209 participants were included in the study who had COVID-19 disease (PCR-positive) aged 18-75 years. The demographic characteristics and COVID-19 severity data were recorded by questioning the patients. The musculoskeletal pain was also assessed using Visual Analog Scale (VAS) and the extended Nordic musculoskeletal system questionnaire (NMQ-E). In addition, the neuropathic components of pain were evaluated using the Leeds Assessment of neuropathic symptoms and Signs (LANSS) pain scale and the Pain-DETECT questionnaire (PDQ). RESULTS: The mean time elapsed since COVID-19 was 5.76 & PLUSMN;2.95 months (min, 1; max, 12). Six patients (2.9%) had neuropathic pain according to the LANSS score, and 12 patients (5.7%) according to the PDQ score. The NMQ-E indicated that the most pain was detected in the back (20.1%), low back (15.3%), and knee (11.5%) regions during the post-COVID-19 period. According to both neuropathic pain scales; low back pain (p=0.001/0.001) and knee pain (p=0.001/0.01) were more common in patients with PDQ/LANSS neuropathic pain. Logistic regression analysis showed that there were significant associations between neuropathic pain and acute COVID-19 VAS score. CONCLUSION: This study demonstrated that musculoskeletal pain was prominent mostly in the back, low back, and knee during the post-COVID-19 period. The incidence of neuropathic pain was 2.9%-5.7% depending on the evaluation parameters. Neuropathic pain is a finding that should be considered during the post-COVID-19 period.