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Biomedical subjects

J C Gerster

Publications and source records attributed to J C Gerster.

At least 91 records · Page 5Linked to original sources

[A case of severe rarefaction osteopathy associated with tabes dorsalis].

The authors report the case of a 63 years old man who presented 13 years after a diagnosis of a tabes dorsalis, stress fractures of the lower limbs and Charcot's joints (knees). 7 years later, he had multiple stress fractures of the sacrum and pelvis and of the ribs following a minor trauma. Laboratory investigations revealed a major osteoporosis probably related to the neurochirurgical complications of the tabes dorsalis.

Fractures, Stress↗

[Fractures due to bony insufficiency of the sacrum].

Six cases of insufficiency fracture of the sacrum were diagnosed in the Rheumatic Diseases Division of the CHUV during 1990. They show that this recently described entity is frequent. Present knowledge of the clinical course, predisposing factors, radiological findings and treatment is reviewed. This diagnosis should be considered in all cases of lower back pain occurring in postmenopausal women. Awareness of this entity should make it possible to avoid unnecessary invasive investigations.

Aged↗

[Still's disease in adults with disseminated intravascular coagulation].

Coagulation abnormalities are not included in the definition of adult onset Still's disease (AOSD). Nevertheless, eight cases with disseminated intravascular coagulopathy (DIC) sometimes associated with hepatopathy have been reported in the literature. The first patient, a 39-year-old woman, presents an AOSD well stabilized under steroid therapy since 1986. In 1989, she develops a DIC, a pancytopenia and a non-specific hepatopathy with a good response to an intensive steroid therapy and heparin. The second patient, a 30-year-old woman, presents since the age of three years, with juvenile Still's disease in remission since the age of 19. At the age of 28, she presents an AOSD, complicated by DIC which necessitated the introduction of methotrexate given for the poor response to high doses of steroids. The etiology of AOSD and DIC is still unknown. An iatrogenic cause (salicylates, indomethacin, chrysotherapy) has been suggested. An AOSD with DIC (sometime associated with an important hepatopathy and/or pancytopenia) should be treated early with corticosteroids and heparin in order to prevent a possible lethal outcome.

Adult↗

[Metastasis of pulmonary origin in a metatarsal head: differential diagnosis of an attack of gout. Literature review of bony metastases of hands and feet].

The osseous metastasis in our patient's first toe has been the initial clinical manifestation of a pulmonary neoplasm and the clinical picture was that of a gout-attack or an other osteoarticular affection. As a rule, primary supradiaphragmatic neoplasia tend to metastasize to the hands whereas primary infradiaphragmatic neoplasia tends to metastasize to the feet. Our patient, who presented a pulmonary tumor with a metastasis in the right foot, did not fit into this schedule.

Adenocarcinoma↗

[Pain in the lower limb as a manifestation of an osteoid osteoma. Apropos of 2 cases].

The case history of two young men suffering from osteoid osteoma is described as follows. The clinical features, the mechanism of pain, the differential diagnosis, investigations and treatment are discussed in accordance with the recent review of the literature. The OO is a benign bone tumor, with no systemic signs characterized by nightly pain which is greatly improved by small doses of NSAID. Mostly young men between 10 and 20 years suffer from this lesion which can be completely cured by surgical excision of the nidus en bloc.

Adult↗

[Apatite tenosynovitis of the hand].

Three cases of apatite tenosynovitis of the hands are presented. This rare condition has often a dramatic outset with an intense inflammation that could suggest an infectious process. The radiographic feature is characteristic, and the examination of the material removed from synovial sheath or from calcific deposits allows apatite crystals to be identified. The process is self-limited, but immobilization and local infiltrations of steroids shorten the duration of disability.

Adult↗

Spontaneous regression of intervertebral disc calcifications in a child.

This article presents the case of a boy who complained of cervical and thoracic spine pain for the first time at the age of nine. Plain films of cervical and thoracic spine showed calcifications of intervertebral disc C4-C5, C5-C6, C6-C7 and D3-D4. The symptoms disappeared after conservative therapy. Plain films taken 16 months later showed spontaneous disappearance of all disc calcifications. This spontaneous regression of intervertebral disc calcifications in childhood has also been described in other cases reported in the medical literature. Except for the rare cases when disc calcifications are associated with disc herniation, the discovery of disc calcifications on a plain X-ray of a child corresponds to a benign abnormality.

Calcinosis↗

Multiple site avascular necrosis in HIV infected patients.

We describe avascular necrosis at multiple sites in 2 young adults. This is a condition rarely seen except in hypercortisonism or hemoglobinopathies. In one case, it occurred in the first trimester of pregnancy. No obvious cause of osteonecrosis could be found but both patients were infected by the HIV. The role of the latter in the bone necrosis is questionable.

Adult↗

[Calcified thoracic herniated disk and chondrocalcinosis].

Thoracic discal hernia is a rare condition which in most cases is associated with radiologic calcifications of the disc, the nature of which remains unclear. However, it is generally accepted that the calcifications consist of apatite. In our observation a calcified discal hernia caused progressive paraparesis. The fact that it occurred in a patient with diffuse chondrocalcinosis suggests that the discal calcification could be due to calcium pyrophosphate deposition.

Aged↗