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Biomedical subjects

D Van Linthoudt

Publications and source records attributed to D Van Linthoudt.

At least 19 recordsLinked to original sources
PubMed2006

[Livedoid dermatitis of the shoulder after a repeated subacromial corticosteroid injection].

Local injection of a steroid compound is a widely used treatment of musculoskeletal diseases. Nevertheless, general and local side effects are not rare. These latter are dominated by the fear for an infection, an inflammatory flare related to the microcristalline structure of the substance or a tendon rupture but they also concern the skin. Usually mild and transitory, they may leave persistent sequellae. We report the case of a woman who developped a livedoid dermatitis of the shoulder secondary to a repeated triamcinolone acetate infiltration for a scapulohumeral periarthritis.

Adult↗
PubMed2006

[Multiple erosive osteoarthritis of the lumbar spine associated with a cystic node of L5].

Osteoarthritis of the spine can predominate on the zygapophyseal joints or on the discovertebral space. In this last localization, it can be characterized by superficial erosions or a cystic lesion into the vertebral body with densification of the vertebral end-plates and small osteophytes. We present the case of an 83 years-old woman with an erosive osteoarthritis at 3 levels of the lumbar spine associated with a large cystic node of L5, revealed by a low energy fall. The absence of fever, a history of tuberculosis, inflammation at the laboratory tests and the aspect of the CT scan allowed the avoidance of sophisticated or invasive explorations. Evolution was good with medical treatment, making unnecessary immobilization into a brace.

Aged↗
PubMed2006

[Recurrent shoulder pain indicative of a tuberculous cervical spondylodiscitis].

Shoulder pain is usually related to local osteoarticular or periarticular diseases of mechanical or inflammatory origin. Occasionally, it can be secondary to a discoradicular compression in the cervical spine. We report the case of a 67-year-old woman who was hospitalized for degradation of her general state, inflammation and painful shoulders. General and ear-nose-throat examinations were normal. Pain was elicited by palpation of the shoulders and the cervical spine. The mobility of shoulders and the neck was complete and painless. Laboratory tests showed inflammation with marked eosinophilia. Plain radiographs of the shoulders were normal. A 99mTc total bone scintigraphy showed an increased uptake ranging from D3 to D12. The thoraco-abdominal CT scan was normal. The evolution after seven months was marked by a occurrence of a sudden tetraparesy. The neck CT scan and magnetic resonance imagery showed a C6-C7 spondylodiscitis. The patient was operated and the symptoms disappeared. The Löwensten's culture of the removed discal tissue was positive and confirmed the presence of a Pott's disease. The evolution was favorable with a specific quadri-therapy for nine months. A negative scintigraphy and the presence of an eosinophilia were misleading in the present case. For shoulder pain without a clear etiology, cervical exploration should be adviced. Cervical tuberculosis can begin with isolated shoulder pain.

Aged↗
PubMed2004

[Fibromyalgia and working ability--experience of a rheumatological appreciation center].

Fibromyalgia is a painful syndrome frequently leading to a rheumatological expertise. Between January 1998 and August 2003, 260 medical appraisals were carried out in the department. Forty-three people matched the fibromyalgia classification criteria proposed by the American College of Rheumatology. This number represents a twofold increase compared to the period ranging from 1968 to 1997. One quarter were men. The group of people with fibromyalgia (Exp. FM+) was compared with a group of patients undergoing a similar evaluation without fibromyalgia (Exp. FM-), matched for age and sex. There were no differences concerning the demographic characteristics nor increase in obesity, heart rate or decreased blood pressure in the Exp. FM+ group. In people mentioning back pain, Waddell tests for a non organic origin of the pain tended to be more present in this group. There were no more triggering events, heavy labor workers or a decreased education level in the Exp. FM+ group. Fatigue, sadness, irritability and evocation of suicide were more frequently noted in the fibromyalgia group. People with work disablement higher than 50% were no more numerous in the Exp. FM+ group. Similarly, the working ability level in the last job or in an appropriated job was not decreased in the Exp. FM+ group. In this study, comparison between people with and without fibromyalgia yielded no great differences and working ability was regarded to be equivalent.

Adult↗
PubMed2004

[Calcium pyrophosphate dihydrate deposition disease in the transverse ligament of the atlas].

Calcium pyrophosphate dihydrate (CPPD) deposits, answerable for chondrocalcinosis, are frequently observed in elderly people. Involvement of the spine is not rare. We present the case of a woman hospitalised for an acute arthritis of the right knee related to CPPD crystal deposition disease who suffered from acute neck pain. The computerised tomography showed calcified deposits in the transverse ligament of the atlas highly suggestive of CPPD deposits. This localisation seems to be very common for CPPD deposits. These CPPD crystal deposits may induce pseudo-meningitic attacks or chronic mechanical neck pain. CPPD crystal deposits in the upper cervical spine should be diagnosed when the disease is quiet, in order to avoid unnecessary investigations and therapies when an acute cervical flare occurs.

Aged↗
PubMed2004

Spontaneous bilateral humeral head fractures occurring simultaneously in a woman with rheumatoid arthritis.

A 67-year-old woman with a 15-year history of seropositive rheumatoid arthritis developed acute night pain in both shoulders. Examination revealed bilateral swelling and joint mobility impairment. Ultrasonography disclosed joint effusions which were hemorrhagic on aspiration. Radiographs showed the presence of a four-part fracture of both humeral heads. Bilateral humeral head fractures can occur spontaneously in patients with rheumatoid arthritis and osteoporosis. Repeated use of crutches could be a predisposing factor.

Absorptiometry, Photon↗
PubMed2004

How to keep a wet preparation of synovial fluid.

Identification of crystals in the synovial fluid (SF) is mandatory for the diagnosis of a microcrystal deposition arthropathy. In some cases, this analysis can be troublesome, especially in medical centers where a qualified practitioner is not continually present. Therefore, we investigated a method for preservation of a wet preparation of SF for 24 hours at room temperature. The procedure consisted in storing the preparation in a closed Petri plate whose bottom was covered by a cellulose compress moistened with saline (0.9% sodium chloride) separated from the slide by 2 wooden or glass sticks. The joint aspirates of 20 consecutive patients with various microcrystal arthropathies were read immediately after aspiration and reviewed after 24 hours on the slides stored according to the previously mentioned procedure. For 11 of the 20 cases, a second SF preparation was stored in normal conditions. The amounts of crystals were estimated semiquantitatively.Preparations stored in the Petri plates were clearly readable after 24 hours and crystals still identifiable on each slide. The amounts of crystals were still the same. After 24 hours, the preparations stored in normal conditions were dry, the shapes of the crystals were blurred, their amount was reduced, and birefringent artifacts were seen. In conclusion, when the amounts of SF are small and a skilled technician or a rheumatologist is not immediately available for reading the preparation, storing the wet preparation of SF in a moistened Petri plate can prove useful.

Journal Article↗
PubMed2003

[Bilateral knee osteoarthritis associated with supracondylar chondromas and popliteal osteochondromas].

The knee is a complicated joint where various diseases can coexist. We present a case of a woman with bilateral knee osteoarthritis who's radiographic follow up allowed a 15 year watch of a bilateral medial supracondylar chondroma and of a popliteal osteochondroma of the both knees. This observation emphasizes the usefulness of repeated radiographs, not only in order to survey the evolution of the knee osteoarthritis but also to disclose the appearance and/or disappearance of other lesions in the neighborhood.

Aged↗
PubMed2002

[Delayed discovery of vertebral sarcoidosis].

Vertebral bone sarcoidosis is rare and may be difficult to diagnose. Clinical manifestations are often poor and the discovery can be fortuitous. We report a case of a 64 year old woman whose vertebral sarcoidosis diagnosis was established 20 years after the primary discovery of a cured thoracic sarcoidosis.

Biopsy↗
PubMed2001

Local deposition of calcium pyrophosphate crystals in evolution of knee osteoarthritis.

The aim of the study was to investigate the frequency of development of local calcium pyrophosphate (CPPD) crystal deposition in patients with knee OA initially found negative for these crystals, as well as to discover whether prognostic indicators for this subset of patients can be found. A clinical follow-up of records of outpatients with idiopathic knee OA was established. An anteroposterior plain radiography of the knee joints was made initially and at the end of the observation period. The follow-up period needed to be more than 1 year. Patients were divided into two groups. The first included patients with knee OA who did not develop intra-articular CPPD crystal deposition during the observation period (OA group). The second included those patients whose X-rays or synovial fluid (SF) analysis in the follow-up showed these crystal deposits to be present (OA + CPPD group). There were 59 patients (42 women, 17 men) who met the selection criteria. During the observation period (8.1 + 7.4 years in the OA group, 10.4 +/- 6 years in the OA + CPPD group), intra-articular CPPD deposits were observed in 15 patients (25%): 10 on the X-rays, eight in the SF and three in both examinations. Age at diagnosis of OA and incidence of obesity were similar in both groups. There was a trend (P = 0.21) towards men developing intra-articular CPPD crystal deposits more frequently than women. OA in only one knee joint was significantly more frequent in the group with CPPD (P<0.01). Of those with CPPD deposits 40% required surgery at the end of the observation period, compared to 27.2% of those without deposits (P = 0.27). The waiting period before knee surgery was shorter in the OA + CPPD group but the difference was not statistically significant. In conclusion, local CPPD crystal deposition was observed in 25% of cases during the evolution of knee OA. No predictive factors were found. OA of the knee could, per se, favour the development of CPPD deposits. The occurrence of intra-articular CPPD deposits seemed to be related to a more rapid and severe evolution of OA of the knee.

Aged↗
PubMed2000

[Rheumatology expertise].

Requests for expert appraisals in cases of osteoarthritic diseases increases continually, especially those addressed by the "Office de I'Assurance Invalidité (OAI)" or private insurances (PRIV). In this series of 413 cases, the mean age of the applicants was significantly lower than that of 10 years ago. There were more men than women, foreigners than Swiss natives and couples than people living alone but not significantly. 85% of complaints were for vertebral pain; fibromyalgia and depression were noted in 8% and 27% of cases respectively. Only 42% of those demanding time off work had heavy work; 66% did not continue their schooling beyond the minimum requirement. Less than 1/3 of work interruption for OAI and 1/6 for PRIV were confirmed; more than 1/2 of the patients for PRIV could not justify a work disability higher than 20%. 19% of our appraisals were disputed; 3% succeeded and 3% are still in progress. Chronic rheumatological complaints do not necessarily result in insurance compensations. Practitioners can contribute to chronification of rheumatological complaints by perpetuating work interruption for non medical reasons.

Adult↗