The heterogeneity of symptoms among patients with fibromyalgia (FM) makes the development of standardized diagnostic criteria challenging. No imaging technique has reliably shown FM-related muscle changes to aid clinical assessment. This study aimed to quantitatively analyze the upper trapezius muscle in FM patients using B-mode ultrasonography and blob analysis and to examine its correlation with clinical parameters. A total of 34 female FM patients and 34 healthy controls were included in this cross-sectional study. B-mode ultrasonography was used to image the dominant-side upper trapezius muscle, and MATLAB-based blob analysis was performed to assess blob size, blob count, and echointensity. These measurements were correlated with disease severity indices, including the Central Sensitization Inventory (CSI), Visual Analog Scale (VAS) for pain, Fibromyalgia Impact Questionnaire (FIQ), 36-Item Short Form Survey (SF-36), and Beck Depression and Anxiety Inventories (BDI, BAI). FM patients had significantly higher total blob size (p < 0.001) and blob size per mm² (p < 0.001) than controls. Echointensity was significantly increased in the FM group (p = 0.009). Total blob size showed a moderate positive correlation with CSI scores (p = 0.002). Regression analysis indicated that pain-VAS was a significant predictor of total blob size per mm² (p < 0.001). Blob analysis demonstrated quantifiable muscle alterations in FM, supporting its potential role as an objective assessment tool. Given the correlation between muscle echotexture and FM severity, quantitative ultrasonography may contribute to a better understanding of FM pathophysiology.

Fibromyalgia (FM) is a multifactorial syndrome involving central sensitization and psychosocial factors such as fear of movement and emotional distress. Ty

Gout is the most common form of inflammatory arthritis, with a growing global prevalence and significant clinical burden. Although effective treatments are available, real-world implementation of guideline-based care remains suboptimal. This study aimed to comparatively evaluate the performance of two large language models (LLMs), ChatGPT-4o and Gemini 2.0 Flash, in responding to structured clinical questions derived from the 2020 and 2016 EULAR guidelines for the diagnosis and management of gout. Both models demonstrated moderate reliability and high response quality. Regarding guideline alignment, ChatGPT-4o provided fully aligned, complete, and accurate responses to 76.0% of the questions, whereas Gemini achieved this in 48.0%. Additionally, 8.0% of Gemini’s responses were entirely contradictory to the guidelines, while ChatGPT-4o had none. ChatGPT-4o significantly outperformed Gemini across reliability, quality, and alignment metrics. Readability assessments indicated that both models generated content requiring college-level comprehension. Both LLMs showed potential in supporting clinical decision-making for gout management. However, ChatGPT-4o consistently produced more accurate and guideline-concordant responses. While these tools may enhance clinical care and education, caution is warranted due to limitations in transparency and consistency.

Objectives: This study aims to determine the validity and reliability of the Turkish version of the Sarcopenia Disease Risk Perception Scale (SDRPS-TR), addressing the lack of disease-specific risk perception tools in Türkiye. Patients and methods: The validation process was conducted in two phases: (i) translation and cross-cultural adaptation of the SDRPS into Turkish and (ii) psychometric evaluation of the SDRPS-TR. A total of 323 Turkish individuals (132 males, 191 females; mean age: 71.6±7.8 years; range, 60 to 93 years) were included between December 2024 and January 2025. Content validity was assessed using the content validity index. Construct validity was evaluated through exploratory factor analysis and confirmatory factor analysis. Reliability was assessed by measuring internal consistency (Cronbach’s alpha), test-retest reliability (intraclass correlation coefficient, ICC), and split-half reliability (Spearman-Brown coefficient). Results: Content validity index values ranged between 0.85 and 1.00, confirming strong content validity. Exploratory factor analysis identified a two-factor structure (perceived susceptibility and perceived severity), explaining 55.8% of the variance. Confirmatory factor analysis confirmed the model fit with acceptable indices. The SDRPS-TR demonstrated high internal consistency (Cronbach’s alpha=0.929) and excellent test-retest reliability (ICC=0.844, 95% confidence interval 0.764-0.907). Conclusion: The SDRPS-TR is a valid and reliable instrument for measuring sarcopenia risk perception among Turkish older adults. The availability of SDRPS-TR provides important opportunities for the early identification of at-risk individuals. It also supports clinical screening and community-based health education efforts, contributing to timely intervention for sarcopenia.

Background: Lipedema is a chronic adipose tissue disorder primarily affecting women, characterized by abnormal fat accumulation, pain, and reduced mobility. Its impact on sexual function remains underexplored. This study aimed to evaluate sexual function in women with lipedema and examine its associations with anxiety, depression, lower extremity function, and quality of life. Methods: In this cross-sectional study, 100 sexually active women were recruited: 50 with lipedema and 50 age- and Body Mass Index-matched healthy controls. Sexual function was assessed with the Female Sexual Function Index (FSFI); anxiety and depression with the Hospital Anxiety and Depression Scale (HADS-A and HADS-D); quality of life with the EuroQOL 5-Dimensional 5-Level (EQ-5D-5L) instrument; lower extremity function with the Lower Extremity Functional Scale (LEFS); and pain intensity with the Visual Analog Scale (VAS). Multiple linear regression analysis was conducted to identify the factors associated with the total FSFI score. Results: Women with lipedema had significantly lower total FSFI scores compared to controls (21.58 ± 3.99 vs. 25.86 ± 3.21, P < .001), with 76% having FSFI scores below the cut-off (≤ 26.55) compared to 36% of controls. All FSFI domain scores were significantly lower in the lipedema group (all P < .05). In the lipedema group, there was a significant correlation between total FSFI scores and age (P = .002), pain intensity (VAS; P = .022), depression (HADS-D; P = .010), quality of life (EQ-5D-5L index; P = .027), and lower extremity function (LEFS; P < .001). Multiple linear regression analysis identified depression (HADS-D; P = .047), perceived health status (EQ-5D-5L VAS; P = .033), and lower extremity function (LEFS; P = .011) as independent variables that had a significant relationship with the total FSFI score. Discussion: Lower sexual function is common among women with lipedema and is associated with anxiety and depressive symptoms, lower extremity function, and pain intensity. These findings highlight the importance of incorporating sexual function assessment into the routine evaluation of patients with lipedema and support the need for comprehensive multidisciplinary treatment approaches addressing physical, psychological, and sexual health aspects of care.