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Biomedical subjects

L Lucet

Publications and source records attributed to L Lucet.

10 recordsLinked to original sources

Computed tomography of the normal sternoclavicular joint.

OBJECTIVE: The objective of this work was to establish a reference population for the study of the sternoclavicular joint (SCJ). DESIGN: A prospective study of the SCJ was carried out by high-resolution computed tomography (CT). CT images were read by two radiologists and two rheumatologists using a pre-established grid (27 elementary signs). PATIENTS: Sixty healthy subjects, homogeneously distributed by sex and decade of life, from 20 to 80 years old, were studied. RESULTS AND CONCLUSIONS: The main results were the following: 98% of healthy subjects presented at least one sign; mean number of signs per subject was 2.4 +/- 1.9; mean number of signs was higher ( P < 0.005) in men (mean = 3.1 +/- 2.1) than in women (mean = 1.7 +/- 1.3); number of signs increased with age (P < 0.001). Some signs were very frequent: "ossification of the first costal cartilage" (88%), "Surrounded subchondral clavicular erosion" (27%). Some signs were significantly more frequent in the elderly: "sternal osteophyte" after the age of 70 (P < 0.01) and "meniscal calcification" (P < 0.01) and "sternal subchondral sclerosis" (P < 0.05) after the age of 60. The number of clavicular signs was greater than that of sternal signs (P < 0.001). These results can be used as references for the study of the SCJ.

Adult↗

Aspergillus spondylodiscitis: successful conservative treatment in 9 cases.

OBJECTIVE: To assess the effectiveness of medical treatment by clinical, radiological, and biological analysis of outcome in 9 patients with aspergillus spondylodiscitis. METHODS: Retrospective study including 9 patients with aspergillus discitis, in which 7 were immunosuppressed; 3 were heart transplant patients, 2 had acute lymphoblastic leukemia, 1 hairy cell leukemia and one was receiving prednisone for bronchial asthma. Four patients had isolated spinal aspergillosis infection. In 4 cases, disc space infection occurred after pulmonary aspergillosis. In the last case the spondylodiscitis occurred after aspergillus endocarditis and mycotic limb embolism. In all cases a percutaneous needle biopsy of the intervertebral disc was performed; the subsequent culture produced Aspergillus fumigatus in 8 cases and Aspergillus flavus in 1. Itraconazole was given to all patients (mean dose: 350 mg/day); it was given alone in 2 cases, in addition to 5 flucytosine and amphotericin B in 6 cases, and in addition to amphotericin B in the last case. RESULTS: Improvement was obtained in the 9 cases, with full recovery in the absence of any surgical debridement after a mean treatment duration of 5.5 months and a mean followup delay of 16 months. CONCLUSION: Early recognition of aspergillus spondylodiscitis in immunocompromised hosts is important. Itraconazole alone or in combination is an effective therapy. There may be an increased incidence of aspergillus discitis due to the increasing frequency of immunosuppression associated conditions including organ transplantation, chemotherapy, or acquired immune deficiency syndrome.

Adult↗

[Aspergillus spondylodiscitis. Apropos of 3 cases].

Three cases of Aspergillus discitis are reported in immunodepressed patients. Vertebrae osteomyelitis was preceded in 2 cases by pulmonary infection. The diagnosis was established in every case by disc aspiration or closed-needle-biopsy and mycological examination of the material. Aspergillus fumigatus was identified in two cases; in one case itroconazole led to recovery within three months.

Adult↗

[Intradural metastasis. Value of magnetic resonance imaging].

Imaging a 70 year old man with lymph node metastases from an adenocarcinoma developed cauda equina syndrome. The diagnosis of intradural metastatic disease was established on the basis of magnetic resonance imaging with gadolinium injection which visualized diffuse nodules in contact with the nerve roots.

Adenocarcinoma↗

[Osteoarticular manifestations of palmoplantaris pustulosis. A prospective study of 15 cases].

Between 1986 and 1989, we conducted a clinical, biochemical, radiological and scintigraphic prospective study of 15 patients (8 men, 7 women) with histologically proven palmoplantar pustulosis. In 70 percent of the cases the time interval between the first cutaneous and the first osteoarticular signs was 2 years. Anterior thoracic clinical manifestations were frequent. The joints and the numbers of patients involved were: sternoclavicular (12), manubriosternal (6), sternocostal (5), intervertebral (11), sacroiliac (6) and peripheral (10). Two patients had osteitis. The clinical, radiological and scintigraphic findings, as well as the distribution of these arthropathies over the anterior thorax (i.e. over a sternocostoclavicular complex with numerous ligaments), suggest a preference for entheses. Despite the absence of link with the HLA B27 antigen, the frequent association with pelvic and spinal lesions indicate that the articular disease of palmoplantar pustulosis is a spondyloarthropathy.

Adolescent↗