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P Chertok

Publications and source records attributed to P Chertok.

9 recordsLinked to original sources

Lumbar posterior marginal node (LPMN) in adults. Report of fifteen cases.

This report concerns 15 adults (nine men and six women) who experienced lumbar and sciatic pain associated with an unusual defect of the edges of the vertebral bodies together with a small bony ridge protruding into the spinal canal. This lesion was well demonstrated by computed tomography and easily differentiated from the posterior longitudinal ligament or herniated disc calcifications, as well as from posterior degenerative ridge osteophytes. This lesion looked like the so-called lumbar posterior marginal node. First described in adolescents, this entity was considered as a traumatic fracture of the posterior ring apophysis. Recently, identical cases were noted in young adults in the absence of previous trauma, which were a particular type of marginal cartilaginous node. In the cases reported here, the computed tomographic scans suggested several mechanisms of formation of the vertebral lesion: a variant of marginal cartilaginous nodes; traumatic avulsion; avulsion related to disc herniation; and fusion of the avulsed bony fragment with the vertebral body.

Adult

[Cutaneous lesions in POEMS syndrome. Apropos of 3 case reports and a review of the literature].

We present three new cases of POEMS syndrome with the most common cutaneous signs of this entity. The syndrome is a multivisceral complex, mostly described in Japanese patients, which includes polyneuropathy, organomegaly, endocrine disorders, monoclonal gammopathy and skin changes. The latter are constant but sometimes reduced to one type of lesion. The most frequent are hyperpigmentation sparing the mucosae, hypertrichosis, scleroderma-like skin thickening and capillary angiomas. The other signs are much less common, as shown in table I. Histological findings are seldom reported and usually have little specificity. None of these abnormalities is pathognomonic, but their predominance at the extremities may be suggestive and leads to a search for other elements of the syndrome, notably gammopathy. The main differential diagnostic problem is with scleroderma, sometimes circumscribed and often systemic. Some cases are very ambiguous. The relationship between the two diseases would suggest the existence of one or several common pathogenic factors. The overall physiopathology of POEMS syndrome is obscure. The role of endocrine disorders in the genesis of the cutaneous signs is subject to discussion: hyperoestrogenism may explain some of these signs, but hypertrichosis is incompatible with the frequent finding of low androgen secretion. The role of one or several "toxic" substances secreted by plasmocytes is highly hypothetical. In some cases, the skin abnormalities have regressed after treatment of gammopathy, and in rare patients the recurrence of gammopathy was followed by that of skin lesions. In a few cases, a "paraneoplastic" character may be suspected.

Adult

Pubic post-fracture osteolysis simulating a malignancy.

The authors report one case of pubic post-fracture osteolysis, an uncommon and as yet not well understood pathology. It corresponds to an unusual healing of an insufficiency fracture in osteoporotic patients. Its pathogenesis is unclear, but the biomechanical theory seems to be the most convincing.

Biomechanical Phenomena