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Rafik Zouari

Publications and source records attributed to Rafik Zouari.

9 recordsLinked to original sources

Tuberculosis of the greater trochanter: a report of three cases.

Trochanteric tuberculosis represents less than 2% of all musculo-skeletal tuberculosis. The diagnosis is difficult especially if abscess and fistula are missing. The authors report 3 cases of trochanteric tuberculosis. The diagnosis was established, respectively, 4, 9 months and 1 year after the beginning of the symptoms. The tuberculosis was plurifocal in all cases. Diagnosis was based on the presence of caseum granuloma in the first case, positive Lowenstein culture in the second case and on clinical and paraclinical arguments in the third one. Healing was obtained after medical treatment alone. The authors discuss the potential role of the newer imaging modalities in diagnosis of trochanteric tuberculosis and the indications of medical and surgical treatment.

Adult↗

[Rheumatologic manifestations of hypothyroidism].

Rheumatologic manifestations are varied during the hypothyroidism. They can be articular, abarticular, muscular or osseous, consequences of an inappropriate hormonal secretion. Their diagnosis is easy when hypothyroidism is known, but they can be inaugural. Their evolution is favorable under substitute treatment.

Bone Diseases↗

[The association of systemic lupus erythematosus and hypothyroidism. A case report].

The association of systemic lupus erythematosus (SLE) and hypothyroidism is uncommon, and concerns essentially the autoimmun thyroiditis. However, the coexistence SLE-primary hypothyroidism is exceptional. We report an observation of 25-old woman, who presents a clinical form of hypothyroidism, confirmed by hormonal tests, and which is associated to polyarthritis and proximal myopathy non ameliorated by opotherapy. The explorations conclude in SLE. A favourable evolution of muscular and articular signs is obtained with corticotherapy.

Adult↗

[Rheumatologic manifestations of parvovirus B19 infection].

Rheumatologic manifestations of parvovirus B19 infection is a recent individualization. They are rather frequent and varied and meet at the young adult's. Generally, it is responsible for acute, bilateral and symmetrical arthritis, usually involving distal joints and sometimes associated to signs caused by viral infections. Prolonged articular forms were discribed but are rare being able to sometimes feign a nocive rheumatoid arthritis because of their clinical aspect and of a seropositivity. Axial manifestations were also reported. The diagnosis of the recent infection by the parvovirus B19 can be confirmed by ELISA identification of specific IgM antibodies. The mechanism of the articular manifestations is still unknown and the link between parvovirus B19 and systemic vasculitis is questioned.

Adolescent↗

[Pseudo-polymyositic aspect of amyotrophic lateral sclerosis].

The causes of skeletal muscle weakness are multiple and their diagnosis is difficult, particularly in atypical myopathy. We report the observation of 58-old woman, who presents a muscle weakness of lower limbs with elevation of muscle's enzymes. These symptoms were bound initially to polymyosistis. However, the absence of inflammatory biologic syndrome and the results of muscular biopsy, make this diagnosis unlikely. The aggravation of the myopathy with extension to spinal muscles, the apparition of fasciculations and bulbar signs, the results of the electromyogram pose the diagnosis of amyotrophic lateral sclerosis.

Amyotrophic Lateral Sclerosis↗

[Reactive arthritis].

Reactive arthritis are definied as steriles arthropathies using classic bacteriological techniques. They are due to extra articular infection and are often associated with HLA B27. The outcome of these arthritis is characterised by the recurrence of flares with sometimes appearition of ankylosing spondylitis. The pathogenesis of reactive arthritis is modified when bacterial antigens or alive micro-organisms are discovered in involved joints. Several current works have underlined the interest of antibiotic therapy in the chlamydial reactive arthritis. Chronic forms can justify the use of anti-rheumatic drugs such as salazopyrine.

Adolescent↗

[Osteoporotic vertebral fracture with spinal cord compression].

Osteoporotic vertebral fractures with neurologic complications are rarely reported in the literature. We report a case of a 66-year-old woman who developed an osteoporotic fracture of T6 followed one month later by spinal cord compression without aseptic vertebral osteonecrosis. Diagnosis is based on magnetic resonance imaging and examination of vertebral biopsy specimens. After reviewing the literature, we stress some features: the osteoporotic vertebral fractures does not have any particularity compared to the uncomplicated form; the neurological complication occurs progressively and belatedly; the usual mechanism is the recoil of one of posterior vertebral corners.

Aged↗

[Lupus hepatitis].

We report the case of 42 year-old man who presents an acute polyarthritis associated with systemic manifestation and immunologic disorders related to systemic lupus erythematosus. Hepatic tests show cholostase and cytolysis. Hepatic involvement is linked with systemic lupus erythematosus after exclusion of hepatotoxic drugs, viral hepatitis and absence of anti mitochondrial and anti muscle antibodies. Lupus hepatitis seems to be correlated with autoantibodies to ribosomal P protein. Its treatment remains to be defined.

Adult↗