The usefulness of Tc-99m-MDP bone scintigraphy in detection of articular involvement of Behçet’s disease

Articular involvement was reported to be present in approximately 5-76% of Behçet patients. Therefore, we need a useful non-invasive method to detect articular involvement early in Behçet patients with nonspecific complaints. We aimed to evaluate the usefulness of^99mTc-methylene diphosphonate (Tc-99m-MDP) bone scintigraphy in the detection of the articular involvement of Behçet’s disease (BD). Bone scintigraphy with Tc-99m-MDP was performed in 32 (17 male, 15 female) consecutive patients with BD. The sacroiliac (SI) joints with SI index higher than 1.34 were diagnosed as having sacroiliitis. Although joint complaints were present in only 8 (25%) patients, we detected joint involvement by scintigraphy in 27/32 (84.4%) Behçet patients mostly affecting the knees (62.5%), ankles (59.4%), SI joints (25%), wrists (21.9%), shoulders (18.7%), elbows (12.5%) and hips (3.1%). The articular involvement was monoarticular in four cases (12.5%) and was oligoarticular in the remaining. There was no correlation between joint involvement and age, gender, disease duration, drug usage or other clinical manifestations. Despite the fact that our patients were clinically asymptomatic and had normal pelvis radiography, sacroiliitis was found in 8 patients (25%). Bone scintigraphy is sensitive in the diagnosis of joint involvement allowing earlier diagnosis and showing the presence of articular involvement, especially in SI joints.     

Prevalence of goiter and urinary iodine status of 7-11-year-old children in Malatya province, Turkey

Goiter prevalence and urinary iodine excretion levels were assessed in 568 schoolchildren (317 boys and 251 girls), aged 7-11 years, living in the Malatya province, a well-known endemic goiter area in Turkey. Five hundred sixty-eight children aged 7-11 years consented to thyroid gland palpation and provided a urine sample on the day of examination in April 2004. Median urinary iodine concentration for the total group was 66 microg/L. There was an association between presence of goiter or not and urinary iodine levels (67 microg/L versus 62 microg/L, p=0.000). The median urinary iodine concentration was lower in rural areas than in urban areas (54.6 microg/L versus 59.7 microg/L, respectively) and schoolchildren living in rural areas had significantly lower urinary iodine levels (p=0.000). In conclusion, the present study reports mild iodine deficiency in the Malatya province, despite a mandatory iodization program in Turkey which has been in force since 1998.     

Caustic gastroesophageal lesions in childhood: an analysis of 473 cases

Ingested corrosive agents produce oropharyngeal and gastroesophageal injuries ranging from minor burns to severe necrosis, depending on the agent amount, concentration, and duration of exposure. The aim of this study was to present our patients with corrosive ingestion retrospectively. Four hundred seventy-three children younger than 16 years of age (mean age, 3.7+/-0.1 years) who were admitted to our hospital for suspected corrosive ingestion between the years 1995 and 2003 were studied. Two hundred eighty-six (60.5%) of 473 patients were males. Household bleaches (36.6%) and oven cleaners (23%) were the most frequently encountered corrosive agents. During endoscopy, lesions in the esophagus were recorded in 379 children. Eighty-one of the cases had gastric lesions. During the follow-up, esophageal stricture, esophageal perforation, and gastric outlet obstruction (GOO) developed in 11 cases, 1 case, and 2 cases, respectively. Caustic ingestion of alkali substances such as oven cleaner seem to cause more severe injuries. Early admission to the hospital with clinical and endoscopic evaluation and early surgery when required may reduce morbidity and mortality.     

Bizarre parosteal osteochondromatous proliferation of the little toe

A 19-year-old woman presented with pain at the lateral side of the fifth toe of her left foot, which was separated from the adjacent toe. Initial examination suggested dislocation of the fifth metatarsophalangeal joint due to a past fracture. Radiographs showed a mass arising from the proximal phalanx of the little toe, with no medullary and cortical continuity. Excisional biopsy of the mass was performed, and a histologic diagnosis of bizarre parosteal osteochondromatous proliferation of bone (Nora's lesion) was made.     

Pars plana vitrectomy for ocular complications of Beh?et's disease.

BACKGROUND AND OBJECTIVES: To evaluate the outcomes of vitreoretinal surgery for the ocular complications of Behcet's disease. PATIENTS AND METHODS: This retrospective study included 20 eyes of 15 patients with Beh?et's disease (9 men, 6 women; mean age at surgery, 31.0 +/- 1.8 years; range, 21-44 years) who had undergone vitreoretinal surgery for Behcet's disease at Ondokuz Mayis University, Faculty of Medicine, Department of Ophthalmology, Samsun, Turkey, between January 2000 and September 2003. Postoperative visual acuity outcome, course of uveitis, and complications were evaluated in all patients. RESULTS: Indications for surgery were vitreous opacities in 10 eyes (50%), cystoid macular edema in 5 eyes (25%), epiretinal membrane in 3 eyes (15%), and vitreous hemorrhage in 2 eyes (10%). At the last postoperative follow-up, visual acuity had increased 2 Snellen lines or more in 10 (50%) of 20 eyes. Cystoid macular edema completely improved in 3 (60%) of 5 eyes after vitrectomy. Uveitis attacks significantly decreased during follow-up (P = .015). Immunosuppressive treatment was stopped in 11 (73%) of 15 patients. Retinal detachment and phthisis were not observed in any eye. CONCLUSION: Vitreoretinal surgery may be useful in the treatment of posterior segment complications of Behcet's disease.