TY - JOUR T1 - Romatoid artrit'te kemik sintigrafisi bulguları, DAS28 skoru ve biyokimyasal parametrelerin karşılaştırılması TT - Bone scintigraphy, DAS 28 score and biochemical parameters in patients with Rheumatoid Arthritis AU - Karaçavuş, Seyhan AU - Uçar, Mehmet AU - Geçer, Mehmet Fatih AU - Balbaloğlu, Özlem AU - Nas, Ömer AU - Sarp, Ümit PY - 2015 DA - August Y2 - 2015 JF - Harran Üniversitesi Tıp Fakültesi Dergisi PB - Harran Üniversitesi WT - DergiPark SN - 1304-9623 SP - 255 EP - 260 VL - 12 IS - 2 LA - tr AB - Amaç: Romatoid artrit (RA), eklemlerde ilerleyici hasarla karakterize kronik inflamatuar ve otoimmun birhastalıktır. Bu çalışmada RA'lı hastalarda klinik, biyokimyasal ve sintigrafik bulguların karşılaştırılmasıamaçlanmıştır.Materyal ve metod: Çalışmaya American College of Rheumatology (ACR) kriterlerine göre RA tanısıalmış 62 hasta (K/E: 44/8, yaş ortalaması 51,8±11,1; yaş aralığı 31-77) dahil edilmiştir. Tüm hastalar DAS28(Disease Activity Score) skorlamasına göre hastalar iki gruba ayrıldı; DAS28 skoru ≥3,2 olanlar hastalıkaktivitesi yüksek (Grup 1), <3,2 olanlar hastalık aktivitesi düşük (Grup 2) olarak tanımlandı. Tüm hastalaraTc99m-MDP ile yapılan kemik sintigrafisi yapıldı. Kan havuzu ve geç statik fazda izlenen artmış aktivitetutulumları pozitif bulgu olarak değerlendirildi. Ayrıca hastaların serum biyokimyasal enflamatuarbelirteçlerine (CRP, sedimentasyon, RF) bakıldı. Klinik bulgular Health Assessment Questionnaire (HAQ)ve Ritchie articular index (RAI) ile değerlendirildi.Bulgular: DAS28 skoru yüksek olan Grup 1'de skoru düşük olan Grup 2'ye göre daha fazla sayıda periferikeklem tutulumu (11/8 eklem) gözlendi (p<0.05). Hastalık aktivite skoru yüksek olan grupta klinik skorarttıkça eklem tutulumu sayısı (r=0.5,p=0.019) ve biyokimyasal parametrelerde artış izlendi(r=0.7,p<0.001). DAS28 skoru düşük bulunan 13 hastanın 6'sında ise kemik sintigrafisinde klinik skoruyüksek olan gruptakine benzer sayıda periferik eklem tutulumu saptandı.Sonuç: Romatoid artrit tanılı hastalarda, tüm vücut kemik sintigrafisi, aktif hastalığın bulunduğu periferikeklemlerin tek seansta değerlendirilmesinde ve henüz belirgin klinik bulgu göstermeyen eklemlerintespitinde, klinik yaklaşıma önemli katkıda bulunan, ucuz ve kolay uygulanabilen bir yöntemdir.  KW - Romatoid artrit KW - DAS28 skoru KW - kemik sintigrafisi KW - biyokimyasal parametreler. N2 - Background: Rheumatoid arthritis (RA) is a chronic inflammatory and autoimmune disease characterizedby progressive damage of joints. In this study, we investigated the relationship between the disease activity scores and bone scan findings and biochemical parameters in patients with RA.Method: Sixty two patients (F/M: 44/8, age 51,8±11,1; range 31-77) diagnosed with RA according to theAmerican College of Rheumatology (ACR) criteria were included in the study. All patients were divided totwo groups regarding their DAS28 score; Group 1 was DAS28 score≥3,2 and Group 1 was DAS28score<3,2. The whole body bone scintigraphy with Tc99m-MDP (TVKS) was performed all subject. Aincreased uptake on any joint in blood pool phase and late static phase of bone scan was evaluated as apositive result. Laboratory data including the erythrocyte sedimentation rate and C-reactive protein wererecorded. The clinical parameters were assessed by the Health Assessment Questionnaire (HAQ) and Ritchiearticular index (RAİ).Results: The mean number of peripheral joint involvement was higher in Group 1 than in Group 2 (11/8;p<0.05). Number of joint involvement (r=0.5,p=0.019) and biochemical parameters (r=0.7,p<0.001) wereincreased with clinical score in Higher disease activity score group. In 6 of 13 patients of lower DAS28group, number of peripheral joint involvement were similar to high DAS28 group.Conclusion: Whole body bone scintigraphy is a cheap and easy method, that contributes a lot to the clinicalapproach in patients with rheumatoid arthritis, in the evaluation of peripheral joints in a single session anddetermining the joints those not expressing significant clinical findings yet. CR - 1- Grassi W, De Angelis R, Lamanna G, Cervini C. The clinical features of rheumatoid arthritis.Eur J Radio. 1998;27(1):18-24 2-Goldring SR. Pathogenesis of bone and cartilage destruction in rheumatoid arthritis. Rheumatol 2003;42 (2):11-6 3-Backhaus M, Kamradt T, Sandrock D, Loreck D, Fritz J, Wolf KJ, Raber H, Hamm B, Burmester GR, Bollow M. 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