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Pachydermodactyly (PDD) is a benign, acquired digital fibromatosis characterized by asymptomatic and progressive swelling of periarticular soft tissue, and is usually seen in young men. The etiology of PDD is not fully understood, but is thought to be due to the result of recurrent mechanical stimulation. PDD is usually diagnosed by clinical evaluation. There are thick collagen bundles and collection of dermal mucin in the histopathology. Treatment is not indicated due to benign prognosis. Rheumatologic diseases, particularly rheumatoid arthritis, affecting the joints of the hands should be considered in the differential diagnosis due to the similarity of the joint involvement.

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Objectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items. Afterwards, each recommendation was brought forward for discussion and any alteration gaining ≥70% approval was accepted. Also, Turkish version of each item was rearranged. Last version of the recommendations was then revoted to determine the level of agreement. Levels of agreement of the two voting rounds were compared with Wilcoxon signed-rank test. In case of significant difference, the item with higher level of agreement was accepted. In case of no difference, the changed item was selected.Results: Four overarching principles and 12 recommendations were assessed among which three overarching principles and one recommendation were changed. The changed overarching principles emphasized the importance of physical medicine and rehabilitation specialists as well as rheumatologists for the care of RA patients in Turkey. An alteration was made in the eighth recommendation on treatment of active RA patients with unfavorable prognostic indicators after failure of three conventional disease modifying anti-rheumatic drugs. Remaining principles were accepted as the same although some alterations were suggested but could not find adequate support to reach significance. Conclusion: Expert opinion of the TLAR for the treatment of RA was composed for practices in Turkish rheumatology and/or physical medicine and rehabilitation clinics.

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Melorheostosis is a rare nongenetic developmental anomaly first described in 1922 by Leri and Joanny. Its etiology is unknown. Patients present at any age, and both sexes are affected equally. Onset is usually insidious, with pain, stiffness and limitation of motion at the affected areas. The characteristic radiographic appearance consists of irregular hyperostotic changes of the cortex, generally on one side of the bone, resembling melted wax dripping down one side of a candle. There is usually a demarcation line between the affected and normal bone. Dense, sclerotic linear areas are seen mainly in the cortex but also extending into the cancellous bone. Melorheostosis affects mainly the long bones of the upper and lower limbs, but also the short bones of the hand and foot and, rarely, the axial skeleton may be affected. Bone scintigraphy is positive and shows moderately increased uptake of tracer in all three phases. Computed tomography and magnetic resonance imaging can further characterize the lesion, but rarely contribute to the diagnosis. Treatment of this chronic condition consists of conservative therapies or surgical soft-tissue procedures and even, in very severe cases, amputation. In this case report, a 53 years old male patient with pain and morning stifness in his left hand for 6 months who has been diagnosed as melorheostosis by radiographic appearence is presented.

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Bu araştırmada ülkemizdeki romatizmal hastaların alkol kullanım alışkanlıkları değerlendirildi.Hastalar ve yöntemler: Romatoid artrit (RA), ankilozan spondilit (AS) hastalarından ve sağlıklı kontrollerden oluşan toplam 332 denek [185 erkek, 147 kadın; yaş ortalamaları sırası ile 41.2 (%95 GA 39.5-43.0) ve 45.2 (%95 GA 43.4-47.1) yıl], alkol kullanım alışkanlığı olup olmadığına yönelik olarak sorgulandı. Alkol kullanım alışkanlığı olanlardan Michigan Alkolizm Tarama Testi'nin (MATT) Türkçe versiyonunu yanıtlamaları istendi.Bulgular: Deneklerin toplam %37.3'ü alkol kullanıyordu. Erkeklerin yaklaşık %50'si, kadınların ise %20'si alkol tüketim alışkanlığına sahipti. En düşük alkol kullanım oranı RA grubunda (%23.0), en yüksek oran ise sağlıklı kontrol grubunda (%45.6) idi. Ortalama MATT skoru, RA ve AS grupları için sırasıyla 3.02 (%95 GA: 2.36-3.69) ve 3.13 (%95 GA: 1.76-4.5) olarak bulundu ve her iki değer de kontrol grubuna ait değerden istatistiksel olarak anlamlı oranda küçüktü [4.94 (95% GA: 4.14-5.73) p<0.001]. Michigan Alkolizm Tarama Test skorunun kategorize edilmesi ile yapılan analiz sonucunda alkol bağımlılığı olan deneklerin büyük oranda sağlıklı kontrol grubunda olduğu görüldü.Sonuç: Bizim sonuçlarımıza göre, önemli bir halk sağlığı sorunu olan alkol tüketiminin romatizmal hastalar arasında önemli bir sorun yaratacak boyutta olmadığı ortaya çıkmıştır. Romatizmal hastaların alkol tüketim alışkanlıkları üzerinde rol oynayan potansiyel faktörlerin daha geniş kapsamlı çalışmalarla araştırılması gerekmektedir