Methotrexate in chronic-recurrent calcium pyrophosphate deposition disease: no significant effect in a randomized crossover trial.

Introduction: Calcium pyrophosphate deposition (CPPD) may cause severe arthropathy, major joint destruction and treatment options are limited. The aim of this study was to test the therapeutic efficacy of methotrexate (MTX) in chronic or recurrent CPPD arthropathy.

Methods: Patients with CPPD arthropathy were randomized to receive either weekly subcutaneous injections of 15 mg/week of MTX or placebo (PBO) for three months, in a double-blind, crossover randomized controlled trial.

Pathogenic role of basic calcium phosphate crystals in destructive arthropathies.

Background: basic calcium phosphate (BCP) crystals are commonly found in osteoarthritis (OA) and are associated with cartilage destruction. BCP crystals induce in vitro catabolic responses with the production of metalloproteases and inflammatory cytokines such as interleukin-1 (IL-1). In vivo, IL-1 production induced by BCP crystals is both dependant and independent of NLRP3 inflammasome.

[The humeroradial impingement].

Lateral pain of the elbow is frequently reported. Impingement of the humeroradial fold or a synovial fringe is a seldom evoked cause, sometimes ignored. Nonetheless, this etiology should be remembered in young adults performing sport activities and in heavy workers.

[Clinical presentation imaging and treatment of digital osteoarthritis].

Digital osteoarthritis relates to primarily the distal interphalangeal (DIP) and first carpometacarpal (CMC-I) joints. Heberden's nodes often accompany osteoarthritis of the DIP joints. Osteoarthritis of the PIP joints can be more painful and more inflammatory.

Miller-Fisher syndrome in a patient with rheumatoid arthritis treated with adalimumab.

Adalimumab is a frequently prescribed TNFalpha inhibitor for treatment of rheumatoid arthritis. We report on a patient who probably developed a Miller-Fisher syndrome after the second injection of adalimumab.

[Rotator cuff tear of the hip].

We report the observations of two women with a recurrent periarthritis of the hip complicated by a spontaneous rupture of the tendons of the gluteus medius and minimus. These patients usually complain from an acute lateral hip pain and show a Trendelenburg gait. When the rupture is complete, clinical evaluation reveals a drop of the pelvis on the non-stance side and resisted rotation starting from the extreme external rotation position is weak.

Suspected gouty tophus in a woman's breast.

A postmenopausal woman treated with diuretics for hypertension and who underwent surgery for a previous fibroadenoma of the left breast presented, in December 2003, with a sudden bloody discharge of the left nipple with local swelling, redness, and pain. Radiologic investigations revealed a well-delimited tumor under the areola. Needle aspiration disclosed many histiocytes but no bacteria.

[A practical approach to diagnosing and managing post-menopausal osteoporosis].

Postmenopausal osteoporosis is a major challenge in Medicine. From a simple 10 points questionnaire allowing the detection of the main risks of the disease, different treatment options, based on mineral density, are now available. Treatment should be adapted to age and way of life of the patient.

[Slow-acting anti-rheumatic agents: recent developments].

Until recently, treatment of osteoarthritis targeted the pain and the disability of the involved joints. It consisted in a mix of analgesics, anti-inflammatory drugs, steroid infiltrations and physical therapies. Usefulness of slow but long acting substances is increasing not only by their action on the symptoms but also because they positively influence the evolution of the disease.

The cervical spine in calcium pyrophosphate dihydrate deposition disease. A prevalent case-control study.

Objective: To test the hypothesis that calcium pyrophosphate dihydrate (CPPD) deposition disease is a risk factor for neck pain.

Methods: A prevalent case-control study was conducted to assess cervical calcifications and neck pain between patients with and without known peripheral CPPD deposition disease. CPPD cases were included if diagnosed with CPPD deposition disease of peripheral joints, and excluded if their chief complaint was neck pain.

Rotator cuff repair. Long-term results.

Objectives: To evaluate the results of rotator cuff repair and to look for preoperative and/or intraoperative predictors of long-term outcomes.

Patients And Methods: All patients who underwent open rotator cuff repair surgery for a full-thickness tear between 1990 and 1996 and who were subsequently followed-up for at least 4 years were contacted. The surgical technique and postoperative rehabilitation program were standardized.

Candida glabrata spinal osteomyelitis involving two contiguous lumbar vertebrae: a case report and review of the literature.

Due to the increase of the immunocompromised population, mucosal and systemic infections caused by Candida glabrata, formerly known as Torulopsis glabrata, have shown a recent significant increase. We present a case of C. glabrata vertebral osteomyelitis which required repeated surgical therapy, a complete L2 and L3 corporectomy and more than one year of hospitalisation to complete healing.