Changes in the incidence and management of spinal tuberculosis in a French university hospital rheumatology department from 1966 to 2010.

Introduction: Two previous single-center studies in a university hospital rheumatology department suggested an increase in the incidence of spinal tuberculosis in France in the 1990s. Our objective in this study was to obtain incidence data on spinal tuberculosis since 1995 in the same department and to describe changes over the entire study period from 1966 to 2010. We also compared patients seen between 1966 and 1995 to those seen between 1995 and 2010.

Efficacy in current practice of switching between anti-tumour necrosis factor- α agents in spondyloarthropathies.

Objective: Anti-TNF-α agents are remarkably effective in the treatment of SpAs. However, 30% of patients withdraw from anti-TNF-α agents yearly because of inadequate efficacy or side effects. The objective of this study was to assess in current practice the response to a second and a third anti-TNF-α.

Pregnancy during TNFalpha antagonist therapy: beware the rifampin-oral contraceptive interaction. Report of two cases.

We report two cases of pregnancy in patients taking TNFalpha antagonists for chronic inflammatory joint disease. A factor in both pregnancies was the use of rifampin concomitantly with a combined oral contraceptive. Both patients were taking rifampin and isoniazid for tuberculosis prophylaxis in compliance with French recommendations for patients with positive intradermal tuberculin tests who are scheduled to receive biotherapeutic agents.

Evaluation of bone loss and its mechanisms in anorexia nervosa.

The purpose of this cross-sectional study was to assess the extent of and mechanisms involved in bone loss in anorexia nervosa patients. We compared 113 anorexia nervosa patients (mean age 25 +/- 8 years, mean duration of disease 5.7 +/- 6.

Magnetic resonance imaging of the hand for the diagnosis of rheumatoid arthritis in the absence of anti-cyclic citrullinated peptide antibodies: a prospective study.

Objective: To assess the practical usefulness of magnetic resonance imaging (MRI) in establishing a positive diagnosis of rheumatoid arthritis (RA) in a cohort of patients with early inflammatory polyarthralgia, in the absence of anti-cyclic citrullinated peptide (anti-CCP) antibodies.

Methods: We prospectively followed 30 outpatients with inflammatory polyarthralgia and/or synovitis of at least one joint. Patients were disease modifying antirheumatic drug-naive and received no corticosteroids.

Information and low back pain management: a systematic review.

Study Design: A systematic search of three electronic databases was done to identify randomized controlled trials on the effect of written or audiovisual information in low back pain.

Objectives: To determine whether information is an effective preventive action and/or therapy for low back pain and which type of information is most effective.

Summary Of Background Data: Information is commonly used in the primary care of low back pain and mostly delivered by booklets.

Ultrasonographic assessment of arterial cross-sectional area in the thoracic outlet on postural maneuvers measured with power Doppler ultrasonography in both asymptomatic and symptomatic populations.

Objective: The purpose of this study was to evaluate the feasibility and potential usefulness of power Doppler ultrasonography (PDU) in the assessment of changes in arterial cross-sectional area in the thoracic outlet during upper limb elevation.

Methods: Forty-four volunteers and 28 patients with a clinical diagnosis of arterial thoracic outlet syndrome were evaluated by B-mode imaging and PDU. Arterial cross-sectional area was assessed in the 3 compartments of the thoracic outlet with the arm alongside the body and at 90 degrees, 130 degrees, and 170 degrees of abduction.

Streptococcal and enterococcal spondylodiscitis (vertebral osteomyelitis). High incidence of infective endocarditis in 50 cases.

Objective: To characterize the clinical, biological, and imaging features and outcomes of patients with streptococcal and enterococcal spondylodiscitis (SESD).

Methods: This retrospective study of patients with SESD was carried out in 2 departments of rheumatology from 1990 through 2002. Comparison was made with cases of staphylococcal spondylodiscitis (SSD) seen during the same period, excluding postoperative cases.

Chronic neck pain and masticatory dysfunction.

Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment.

The rheumatoid shoulder: current consensus on diagnosis and treatment.

Shoulder involvement is usually inconspicuous in patients with rheumatoid arthritis, and the clinical manifestations are nonspecific. Nevertheless, shoulder involvement should be sought routinely and detected early. Range of motion at the shoulder should be evaluated.

Contribution of percutaneous biopsy to the definite diagnosis in patients with suspected bone tumor.

Objectives: Percutaneous biopsy is widely used for the diagnosis of primary and secondary bone malignancies. The primary objective of this study was to evaluate the contribution of percutaneous biopsy to the definite diagnosis in patients with suspected bone tumor. The secondary objective was to assess the potential diagnostic benefits of a second percutaneous biopsy when the first failed to provide the diagnosis.

Long-term follow-up of vertebral osteoporotic fractures treated by percutaneous vertebroplasty.

The aim of this study was: to assess the long-term efficacy and safety of percutaneous vertebroplasty (PVP) for treating painful vertebral osteoporotic fractures, and to estimate the risk of vertebral fracture in the vicinity of a cemented vertebra. A prospective open study was conducted. PVP were carried out between July 1995 and September 2000 for 16 patients with symptomatic osteoporotic vertebral fracture that had not responded to extensive conservative medical therapy.

Bone metastases revealing primary tumors. Comparison of two series separated by 30 years.

Objective: To compare two series of patients admitted to a rheumatology department for bone metastases 30 years apart and to obtain a pragmatic estimation of the percentage of bone metastases revealing cancer.

Methods: The recent series was composed of 132 patients seen between 1989 and 1996 and the earlier series of 50 patients admitted between 1958 and 1967. All patients were admitted to the same rheumatology department for bone metastases from a diagnosed or undiagnosed primary.

Primary amyloidoma of the axis and acute spinal cord compression: a case report.

Background: Localized primary amyloidosis is a disease characterized by a single tumor and localized amyloid deposit (amyloidoma) with no evidence of generalized amyloidosis. The occurrence of an amyloidoma in the spine is rare and only three cases affecting the axis have been previously reported. We describe the case of a 79-year-old woman presenting with a mass involving the odontoid process, responsible for an acute tetraparesia.

Multiple myeloma presenting with widespread osteosclerotic lesions.

Sclerotic lesions are rare in malignant monoclonal gammopathies, although they are occasionally associated with POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes). In most cases, osseous lesions in POEMS syndrome present as an isolated sclerotic deposit or a combination of both lytic and sclerotic lesions. Diffuse osteosclerosis is extremely rare and may lead to the diagnosis of multiple myeloma, classically known to present as lytic lesions in the skeleton, with or without diffuse osteoporosis.

Bone mineral density changes in hypercalciuretic osteoporotic men treated with thiazide diuretics.

Unlabelled: A few studies suggest that thiazide diuretic agents may have modest beneficial effects on bone. Few data are available on the effects of these medications in patients with osteoporosis and hypercalciuria.

Objective: To evaluate the effects of thiazide diuretic therapy on bone mass and urinary calcium excretion in hypercalciuretic osteoporotic male patients.

Pain management in a rheumatology department: a satisfaction survey.

Objectives: To evaluate the quality of pain management in a teaching hospital rheumatology department.

Methods: We conducted a satisfaction survey among all the patients admitted to the conventional rheumatology department of our teaching hospital over a 1-month period (88 patients with a mean length of stay of 5 d). The patients were asked to complete a questionnaire on the day of discharge.

Total knee arthroplasty in hemophilic arthropathy.

Unlabelled: Chronic arthropathy causes major functional disability in patients with severe hemophilia.

Objective: To evaluate the results of total knee arthroplasty (TKA) and its impact on both quality of life and clotting factor use in patients with severe hemophilia.

Patients And Methods: We evaluated 17 TKAs in 12 patients.

Thoracic outlet: assessment with MR imaging in asymptomatic and symptomatic populations.

Purpose: To compare the dynamic modifications of the thoracic outlet in asymptomatic volunteers and symptomatic patients and assess the presence and location of vasculonervous compressions in these two populations.

Materials And Methods: Thirty-five healthy volunteers and 54 patients with clinical symptoms of thoracic outlet syndrome (TOS) underwent magnetic resonance (MR) imaging of the thoracic outlets with their arms alongside their bodies and after a postural maneuver. Measurements were obtained at the interscalene triangle (thickness of anterior scalene muscle, interscalene angle), at the costoclavicular space (minimum costoclavicular distance, distance between inferior border of subclavius muscle and the anterior chest wall, maximum thickness of subclavius muscle, angle between first rib shaft and horizontal), and at the retropectoralis minor space (distance between posterior border of pectoralis minor muscle and posterior lining of axilla at the passage of the axillary vessels, thickness of pectoralis minor muscle).

Use of disease-modifying antirheumatic drugs in patients with psoriatic arthritis.

Unlabelled: Few prospective placebo-controlled studies have evaluated disease-modifying antirheumatic drugs (DMARDs) in the treatment of peripheral psoriatic arthritis.

Objective: To evaluate second-line treatments used in clinical practice in patients with psoriatic arthritis.

Method: We studied a cross-section of 100 consecutive patients seen by hospital-based or office-based rheumatologists for psoriatic arthritis.