Sevim AKIN, Ahmet İNANIR

Guatr hastalarında kas iskelet sistemi bulgularının değerlendirilmesi

Giriş: Çalışmamızın amacı tiroid bozukluğu olan hastalarda görülen kas iskelet sistemi bulgularının varlığını değerlendirmektir. Materyal ve Metod: Çalışmaya nükleer tıp ünitesine troid sintigrafisi çektirmek amacıyla gelen 123 hasta (100 kadın, 23 erkek) dahil edildi. Troid hormon düzeylerine göre, hastalar hipertroidizm, subklinik hipertroidizm, ötroidizm, subklinik hipotroidizm ve hipotroidizm olmak üzere beş kategoriye ayrıldı. Nörolojik ve kas iskelet sistemi muayenesinden önce duysal semptomları, kas zayıflığı, eklem hareket kısıtlılığı ve kas iskelet sistemi ağrısına ait soruları içeren bir anket doldurtuldu. Nörolojik muayene, eklem hareket açıklığı, eklem şişliği veya efüzyon olup olmadığı değerlendirildi. Osteoartrit tanısına yönelik olarak klinik ve radyolojik özellikler değerlendirildi. Fibromiyalji tanısı ACR kriterleri göz önüne alınarak konuldu. WHOya göre bir T-skoru ≤ -2.5 olanlar osteoporoz olarak, T-skoru ≤ -2.5 ve -1.0 arasında olanlar ise osteopeni olarak sınıflandırıldı. Troid fonksiyonları ise serum TSH düzeylerine göre değerlendirildi. Bulgular: Hastaların 100i kadın (%81), 23u erkek (%19) idi. Kadın hastaların ortalama yaşı 49.99±15.27 yıl (20-87) ve erkek hastaların ortalama yaşı 61.8±12.33 yıl (34-88) idi. Troid bulgularına göre sınıflandırıldığında ise, 21.1% (n=26) hipertroidism, 21.1% (n=26) subklinik hipertroidizm, 49.6% (n=61) ötroid, 4.9% (n=6) subklinik hpotroidizm ve 3.3% (n=4) hpotroidizm olarak saptandı. Hastaların %59unda kas iskelet sistemine ait herhangi bir tanı saptanmadı. Osteoporoz hastaların 23.7% ünü etkileyen en yaygın problem olarak saptandı. Sonuç: Guatrlı hastalarda kas iskelet sistemi semptomlarının varlığı göz önüne alınmalı ve araştırılmalıdır.

Evaluation of musculoskeletal system symptoms in patients with goiter

Purpose: The aim of this study was to investigate the prevalence of musculoskeletal manifestations in patients with thyroid dysfunction. Material and Methods: One hundred and twenty-three patients (100 female, 23 male) who visited the nuclear medicine department for thyroid gland scintigraphy were included in our study. According to thyroid hormone levels, patients were allocated into five categories: hyperthyroidism, subclinical hyperthyroidism, euthyroid, subclinical hypothyroidism, and hypothyroidism. Before neurological and musculoskeletal examinations, a standardized symptom questionnaire was completed including questions about sensory symptoms, muscle weakness, restricted joint mobility, musculoskeletal pain. Neurological examination, range of motion of joints, effusion or swelling of joints was assessed. Diagnosis of osteoarthritis was done by the clinical and radiological characteristics. The diagnosis of FMS was made according to criteria of American College of Rheumatology. According to the World Health Organization (WHO), a T-score ≤ -2.5 was classified as osteoporosis, whereas a T-score between -2.5 and -1.0 was classified as osteopenia. Thyroid status was determined by serum TSH levels. Results: Eighty-one percent of the patients were female (100) and 19% were male (23). Mean age of female patients was 49.99±15.27 years (range 20-87) and mean age of male patients was 61.8±12.33 years (range 34-88). When divided according to thyroid status, 21.1% (n=26) had hyperthyroidism, 21.1% (n=26) had subclinical hyperthyroidism, 49.6% (n=61) were euthyroid, 4.9% (n=6) had subclinical hypothyroidism and 3.3% (n=4) were hypothyroid. None of 59% of patients had any musculoskeletal diagnosis. Osteoporosis was the most common problem, affecting 23.7% of patients Conclusion: The presence of musculoskeletal symptoms in patients with goiter should be considered and investigated.

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