[Muscle weakness and diffuse muscle pain. Osteomalacia, osteoporosis, L4-L5 intervertebral disc displacement].
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Diagnosis, Differential↗
Biomedical subjects
D van Linthoudt
Publications and source records attributed to D van Linthoudt.
Similar radiologic lesions of localized Scheuermann's disease of the lumbar spine in twin sisters.
SUMMARY OF BACKGROUND DATA: Hereditary and mechanical factors are considered to be the principal etiologic factors of Scheuermann's disease. OBJECTIVES: The authors report identical twins presenting similar lesions of localized lumbar osteochondrosis, which were worse in the one twin that practiced strenuous sports activities. CONCLUSIONS: These observations suggest, at least in some of these patients, a basic role for genetic factors in the occurrence of the disease and an influence of mechanical strain on its severity.
Adolescent↗
Tophaceous gout in young patients with systemic lupus erythematosus.
Systemic lupus erythematosus (SLE) and gout have been associated infrequently. We describe 3 young adults with SLE who developed tophaceous gout relatively early in the course of their disease. All were underexcretors of uric acid but were studied after the development of renal disease; 2 were treated with diuretics. In 2 cases, gout became obvious while lupus was quiescent.
Adult↗
Nanocolloid scintigraphy for rheumatic diseases of the hands.
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Colloids↗
[Vertebral and costal stippling. A pitfall in scintigraphy].
Bone scintigraphy is largely used for diagnosis and surveillance of osteoarticular diseases. Interpretation of fortuitous increased isotope accumulation elsewhere on the skeleton may be difficult. We report a man with a peripheral seronegative inflammatory arthropathy, whose bone scintigraphy disclosed stippled ribs and vertebral increased isotope uptake, corresponding to rib enthesopathy and vertebral hyperostosis. Better knowledge of these unusual pictures should prevent further unnecessary investigations.
Aged↗
[Arthritis of the hip associated with infantile toxocariasis].
A parasitic origin of rheumatological manifestations is only suspected if the patient returns from an endemic area of the world. We report a young girl who developed without travelling, an isolated hip arthropathy simultaneously with a Toxocara infestation. Pathogenesis is discussed.
Anti-Inflammatory Agents, Non-Steroidal↗
[Lumbosacral spina bifida associated with an intraspinal lipoma].
Spina bifida is a congenital malformation which occurs during the first weeks after conception. The association with intraspinal tumours, usually lipomas, is well known. During evaluation of back pain, we observed a case of occult spina bifida associated with extra- and intradural lipoma. Simultaneously the patient exhibited cutaneous, orthopedic and neurological signs. The clinical symptoms of lipoma are due to compression and elongation of the spinal cord causing tethered cord syndrome. The onset of neurological symptoms usually occurs in childhood. Late occurrences in adults are often associated with sphincter problems. CT scan and, in particular, magnetic resonance imaging (MRI) provide good visualization of intraspinal lipoma. Treatment is surgical.
Child↗
[Multiple tendon ruptures in a case of calcium pyrophosphate crystal deposit disease (chondrocalcinosis)].
Extra-articular calcium pyrophosphate dihydrate crystal deposition is not rare, but physical disability is nevertheless unusual in such cases. We report the case of an elderly female with calcium pyrophosphate dihydrate crystal deposition disease, who presented with multiple tendon ruptures. The origin of the crystals and the mechanism of the rupture are discussed.
Aged↗
[Osteoid osteoma of the lower end of the femur--a diagnostic problem].
Joint symptoms may be the first manifestations of juxta-articular osteoid osteoma; therefore, diagnosis may be difficult. We report the case of a young athlete who presented an osteoid osteoma of the distal part of the femur. Correct diagnosis was delayed by the presence of a pathological mid-patellar plica synovialis and the absence of modifications on standard X-rays.
Adult↗
[Sclerosis of the anterior arch of the atlas. A rare congenital abnormality].
The authors report the case of a young man with isolated radiological sclerosis of the anterior arch of the atlas, probably of dysplastic origin. The differential diagnosis of this aspect is discussed.
Adult↗
[Contribution to the study of the treatment of osteoporosis using fluoride. Long-term sequelae following discontinuation of fluoride].
Eight idiopathic or postmenopausal osteoporotic patients were studied prospectively over a 4- to 6-year period of treatment with fluoride, calcium, phosphate and vitamin D. After fluoride and phosphate were discontinued they were followed up for a further 6-year period.
Aged↗
[Endoscopic study of digestive lesions caused by the use of nonsteroidal anti-inflammatory agents in rheumatic patients].
44 patients treated with NSAID for a period of over 2 months for a rheumatic disease underwent fibroscopic endoscopy of the upper gastrointestinal tract. Gastric lesions were found to be more frequent than those of the esophagus or duodenum. They occur in men in particular and are not correlated with symptoms or clinical findings. They are likewise unaffected by the presence of inflammatory arthropathy or simultaneous ingestion of coffee or drugs or smoking. Lesions may improve despite continued use of NSAID.
Adult↗
Supraacetabular and femoral head stress fracture during fluoride treatment.
A woman treated with fluoride for corticosteroid-induced osteoporosis presented 1 year later with an unusual localized supraacetabular followed by a same-sided femoral head fracture. Fluoride was increased in serum and urine. Transiliac bone biopsy revealed typical bone fluorosis with elevated trabecular bone fluoride.
Acetabulum↗
Adult septic arthritis with Hemophilus influenzae.
Two cases of Hemophilus influenzae septic arthritis are reported, one in a rheumatoid patient and the other in a healthy young woman after meningitis. The evolution of this rare infectious arthritis was not as good as usual in spite of early therapy. The first patient later presented a Staphylococcus albus bacteriemia and the other a post-infectious persisting arthritis.
Adult↗
Recurrent bilateral insufficiency fracture of the talus. A diagnostic pitfall for ankle pain.
We report on a 75-year-old woman who presented recurrent bilateral ankle pain and swelling related to insufficiency fractures. The diagnosis of this rare condition is difficult since the initial X-rays are usually normal. We may expect an increased frequency of insufficiency fractures of unusual bones with aging of the population.
Aged↗
Morphometric studies on synovium in advanced osteoarthritis: is there an association between apatite-like material and collagen deposits?
OBJECTIVE: To look for the frequency and the influence of apatite-like deposits in the synovial membrane of advanced osteoarthritic joints. METHODS: Synovium of 16 joints undergoing total arthroplasty for advanced primary osteoarthritis was embedded in paraffin. Adjacent sections were stained with alizarin red S, Mowat's pentachrome, Hematoxylin-eosin and Gomori to show apatite-like deposits, collagen, cartilage fragments, vessels, cells and iron respectively. Histomorphometry was carried out for the apatite-like and collagen deposits by the point counting method; the density of vessels and cells was also quantified. RESULTS: 14 out of the 16 specimens contained apatite-like material, mostly on the synovial surface or just beneath. There was no correlation between the apatite-like deposits and any other measured histological parameter (fibrosis, villus length, synovial lining cell width, density of synovial vessels or cells). Interestingly, the p value for a correlation between the amounts of apatite and collagen deposits was close to significance (r = 0.53; p = 0.055) when the relative volume of the apatite-like material was less than 1.2% (n = 13). CONCLUSIONS: Apatite-like deposits are frequently observed in the synovium of late stage osteoarthritis. Although not statistically significant, these results suggest a possible association between apatite-like and collagen deposits when the amount of apatite deposits is low. Further quantitative studies are recommended to investigate this observation.
Aged↗