Isolated Superior Gluteal Nerve Mononeuropathy in Patient with Rheumatoid Arthritis

Romatoid artritli hastalarda izole mononöritis multipleks nadir izlenir. Superior gluteal sinir palsileri total kalça protezi gibi operasyonlar sonrası iatrojenik gerçekleşir. Hastalar lateral uyluk ağrısından şikayet ederler. Hastamızın aynı anda hem bilateral kalça displazisi hem de romatoid artrit hastalığı olması nedeniyle abdominal manyetik rezonans (MR) ve çoklu elektronöromyografi (ENMG) ve laboratuvar çalışmaları yapıldı. Anevrizm ve tümöral lezyonlar gibi malign durumlar öncelikle elendi. Hastanın tanısı romatoid artrite bağlı mononöritis multipleks olarak teşhis edildikten sonra günde 3 kez 800 mg gabapentin ve günde bir kez alfa-lipoik asit 600 mg 6 ay boyunca tedavide kullanıldı. Ek olarak lumbosakral bölge için fizik tedavide konvansiyonel TENS, sıcak paket, kontinue ultrason, güçlendirme ve gevşeme egzersizleri tercih edildi. Şikayetlerinin büyük kısmı tedavi sonrası geriledi. Romatoid artrite bağlı izole superior gluteal sinir mononöropatisi nadir görülen bir durumdur ve de detaylı değerlendirilip uygun şekilde tedavi edilmelidir

Romatoid Artritli Bir Hastada İzole Superior Gluteal Sinir Mononöropatisi

Isolated mononeuritis multiplex may be rarely seen in patients with rheumatoid arthritis. Superior gluteal nerve palsies may result especially from iatrogenic causes, such as total hip arthroplasty operations. Patients complain of burning pain spreading to the lateral side of the thigh region. As our patient had bilateral hip dysplasia and rheumatoid arthritis at the same time, thorough examination was conducted with abdominal magnetic resonance imaging (MRI)’s, multiple electroneuromyography (ENMG) and laboratory studies. Malign illnesses such as aneurysms and tumoral lesions were eliminated. As the patient was diagnosed as mononeuritis multiplex due to Rheumatoid Arthritis, she began to use gabapentin 800 mg three times a day and alpha-lipoic acid 600 mg once a day for 6 months. In addition, she had a physical therapy cure with conventional Transcutaneous Electrical Nerve Stimulation (TENS), continuous Ultrasound (US), hot pack, strengthening and relaxation exercises for the lumbosacral region lasting for three weeks. Most of her complaints subsided after the treatment. Isolated superior gluteal nerve mononeuropathy due to rheumatoid arthritis is a rare presentation and should be thoroughly evaluated and followed for appropriate cures

Kaynakça

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