Comparative Effectiveness of Radial Extracorporeal Shockwave Therapy and Ultrasound-Guided Local Corticosteroid Injection Treatment for Plantar Fasciitis

BACKGROUND

We compared the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) versus ultrasound-guided corticosteroid injection treatment in patients with plantar fasciitis unresponsive to conservative therapy.

METHODS

Seventy-two patients with unilateral plantar fasciitis were randomized to receive either rESWT (three times once per week) (n = 36) or corticosteroid treatment (a single 1-mL dose of betamethasone sodium plus 0.5 mL of prilocaine under ultrasound guidance by injection into the plantar fascia) (n = 36). The primary outcome measures were visual analog scale (VAS) and Foot Function Index (FFI) scores. Secondary outcome measures included the heel tenderness index (HTI) score and plantar fascia thickness (PFT) as obtained by ultrasound examination. All of the assessments were performed at baseline and 1, 3, and 6 months after treatment.

RESULTS

Significant improvements were observed in the rESWT group in VAS, HTI, and FFI scores and PFT at the end of treatment and were maintained during follow-up. Posttreatment improvements in VAS, HTI, and FFI scores and PFT were also seen in the corticosteroid group but were not maintained for VAS and FFI scores after the completion of therapy and were lost at 1 and 6 months, respectively. No serious treatment-related complications occurred.

CONCLUSIONS

Both rESWT and corticosteroid injection therapy are effective modalities for treatment of chronic plantar fasciitis. However, rESWT seems to be superior to corticosteroid injection therapy due to its longer duration of action.

Palmoplantar pustular psoriasis induced by adalimumab: a case report and literature review

TNF-α inhibitors (anti-TNF-α) are agents increasingly used in the treatment of rheumatic diseases resistant to classical disease-modifying treatment and they provide significant improvement of disease activity. However, these agents have many cutaneous side effects including psoriasis. Numerous reports of the induction or worsening of psoriasis in patients treated with TNF antagonists indicate that this is not a rare phenomenon. In this study, we present a patient with ankylosing spondylitis who developed palmoplantar pustular psoriasis after receiving anti-TNF-α therapy for 4 months.

The clinical significance of HPV screening in premalignant cervical lesions

PURPOSE

We evaluated the clinical significance of human papilloma virus (HPV) screening in premalignant cervical lesions.

METHODS

This prospective study was performed at Dicle University, School of Medicine, Department of Obstetrics and Gynecology, from January 2009 to June 2009. A total of 60 cases were evaluated. Thirty cases had premalignant cervical lesions. The prevalence of HPV was analyzed by polymerase chain reaction and types determined by Hybrid Capture II. The cases that had premalignant cervical lesions were evaluated with colposcopy. Statistical analyses were carried out by using the statistical packages for SPSS version 12.0 for Windows (Chicago, IL, USA).

RESULTS

Of all the cases, those with premalignant cervical lesions had higher prevalence of HPV DNA. The cases that had high oncogenic HPV type had more abnormal colposcopic findings.

CONCLUSION

Premalignant cervical lesions should be evaluated by cervical cytology, colposcopy, HPV DNA screening and cervical tissue sampling. In this way, development of cervical cancer can be prevented.

Prevalence of atopy in rheumatoid arthritis in Sivas, Turkey. A prospective clinical study

Assumed mutual antagonism of T-helper cell (Th)1 and Th2 diseases suggests that the prevalence of atopy should be decreased in rheumatoid arthritis (RA). We tried to determine that prevalence. Sixty-two patients with RA and 61 with osteoarthritis (control group) were included in the study. A questionnaire was used concerning mainly the symptoms of atopy. Skin prick tests, pulmonary function tests, chest X-rays, immunoglobulin E levels, and eosinophil counts were obtained. The prevalences of asthma, hay fever, and eczema in the RA group were 3.2%, 14.5%, and 1.6%, respectively. In the control group, they were 6.5%, 22%, and 6.5%, respectively. There was no significant difference between groups. There was also no significant difference between immunoglobulin E levels. Eosinophil counts were higher in the control group, however these values were within the normal range. Skin prick tests were obtained in seven RA patients, and eight controls revealed increased positivity. The prevalence of atopy in rheumatoid arthritis was not different from that in the general population. Our study results cannot support the concept of Th1/Th2 mutual antagonism.