[Surveys of the treatment and socio-professional future of patients with spondylarthritis. Our impressions in 1986].

After a brief historical reminder, the authors emphasize the difficulties of such investigations; difficulties of realization, analysis and synthesis since the results depend on ethnic and socio-cultural origins, socio-professional factors, primary or secondary forms or the length of evolution of the disease. From their experience, the authors draw a certain number of figures which they compare to those from other authors, especially concerning factors which aggravate the functional prognosis of the disease, or condition its complications. As for the therapy, considering the divergent opinions expressed about the results obtained with modern treatments, and used for thirty years, the authors have initiated an opinion survey among the members of the FSR (French Society of Rheumatology).

[Centrosomatic tuberculous vertebral osteitis. General review apropos of 4 cases].

Defined by the localisation of tuberculous infection in the vertebral body, centrosomatic tuberculous vertebral osteitis, which is rarer than Pott's spondylodiscitis, is more frequently seen in the cases of multifocal tuberculosis occurring preferentially in male black African immigrants approximately 30 years of age. Central area destruction, which has been the initial and pathognomonic radiological sign since its description by Calve and Galland , may progress towards wedging of the vertebral body, and even to its complete disappearance, accompanied by reactive osteocondensation . Infection from this particular localisation of vertebral tuberculosis may spread via arterial branches posterior to the vertebral bodies.

[The outcome of reactive arthritis].

Cases of reactive arthritis generally have a favourable short-term outcome, within 1 to 6 months in 50 to 70 per cent of cases. The curable nature of the disease and its short clinical course mean that the therapeutic approach should be devoid of risks. Antibiotics, which are necessary for the mucosal lesion, are ineffective in the joint involvement.

[Results of a regional survey on the treatment of rhizomelic pseudopolyarthritis and temporal arteritis. Apropos of 242 cases treated by various modalities with synthetic antimalarials, corticoids and non-steroidal anti-inflammatory agents].

The authors report the results of a retrospective therapeutic survey concerning 176 cases of rhizomelic pseudopolyarthritis (RPP) and 66 cases of temporal arteritis (TA). Of 128 cases of RPP treated initially by synthetic anti-malarials (SAM) and non-steroidal anti-inflammatory agents (NSAI), 66 were followed up until cure which was obtained after a mean of 23 months and 3 subsequently received brief steroid therapy. 45 cases of RPP were treated initially with corticosteroids.

[Bone mastocytosis and osteomalacia. Apropos of a case with histodynamic analysis on non-decalcified bone].

A patient presented with cutaneous mastocytosis, bone pains, biologic disorders typical of osteomalacia, and intestinal malabsorption. Bone biopsy with histomorphometric analysis and measure of calcification rate on undecalcified bone, confirmed the diagnosis of bone mastocytosis and osteomalacia. There are only 2 other reports of osteomalacia caused by malabsorption.

[Osteomalacia. Histologic definition and significance of the histodynamic analysis on undecalcified bone].

Bone histomorphometry has a major significance in metabolic bone diseases, and especially in osteomalacia. This technique needs a strict methodology with quantitative analysis on undecalcified bone and measure of calcification rate. Histologic definition of osteomalacia includes hyperosteoidosis, characterized by thickened osteoid edges, and decrease of calcification rate.

[Tolerability of pirprofen during prolonged treatment].

During a non-comparative multicentric study, 70 patients suffering from various rheumatological diseases were treated by pirprofen for an average duration of 32 weeks (from 1 to 121 weeks). The daily dose varied from 400 to 1200 mg. Efficacy was judged good or excellent in 53 of the 70 patients (75%).

[Critical study of patella alta. II. Patella alta and femoropatellar pathology].

Patella alta is radiologically defined by an Insall index equal to or greater than 1.3. In 50 patients suffering from pain of the femur and patella, roentgenographic studies consisting of a simple profile view and occasionally completed by a view through Smillie's angle with the knee hyperextended, revealed patella alta.

[Critical study of patella alta. I. Comparison of results of methods for measuring patellar height in 100 control subjects].

The vertical patellar position is a function of patellar tendon length. Various easily-performed radiological techniques can be used to establish indices which define patellar height. 200 measurements were carried out on 100 control subjects who were free of knee joint pathology, and the various techniques were subsequently compared.

[Articular infections in adults. Peripheral and vertebral involvement with common bacteria and tubercle bacteria].

2,166 cases of joint infection in adults were reviewed during a national inquiry. The peripheral infections due to common germs (1,080 cases) and tubercle bacilli (260 cases) were characterised by their frequency after the age of 60, the role of corticotherapy in onset of the infection and the predominance of staphylococci (60%) in pyogenic infections, the low proportion of deaths (4%) and the necessity of early treatment to observe better functional results. The vertebral lesions due to common bacteria (491 cases) were mainly localised in the lumbar regions (70%) whereas tuberculous infections (335 cases) usually affect the lower dorsal vertebrae (50%).

[Fiessinger-Leroy-Reiter disease seen in a rheumatology unit. Apropos of 71 cases].

71 cases of Reiter's disease have been observed since 1972. After a study of the clinical characteristics of these cases, we report the results of 3 laboratory examinations which, grouped together, facilitate the diagnosis of the complete forms, but, above all, of the incomplete and synovial forms. The search for chlamydia cell inclusions was positive in 80% of cases where carried out.

[Multifocal tuberculous osteoarthritis and synovitis. 10 cases].

Synovial or osteo-articular tuberculosis is multifocal in about 10 percent of cases. Here, this form strikes older people and quite frequently the patients receive corticotherapy because of confusion with rheumatism. This premature treatment delays the diagnosis and at the same time favors the spreading of the germ.

[Atrioventricular blocks and rheumatoid arthritis].

Among 379 hospitalized cases of rheumatoid polyarthritis, 12 auriculo-ventricular blocks were detected between 1965 and 1975. The formation of a complete AV block is usually preceded by a branch block or a first degree block. During the installation of a pacemaker, hypoexcitability was usually noted.

[Multicentric reticulohistiocytosis (lipoid dermato-arthritis). Apropos of a case with fatal outcome].

The authors report the case of a 37-year-old man affected by a seronegative polyarthritis associated at first with erythroderma and then with cutaneous and subcutaneous papulo-nodular structures and a xanthomatous eryption. Histological examination of the cutaneous nodules and of the synovial membrane confirmed the diagnosis of multicentred reticulohistiocytosis by showing the presence of lipid infiltrates in the histiocyte cells and of multinucleate giant cells. A study of the ultrastructure of the histiocytes revealed the presence of numerous intracytoplasmic vacuoles.

Results of the rectal administration of ketoprofen in fifty-two patients.

The results of a clinical study of ketoprofen suppositories suggest that the drug is effective when given in this way. It is suggested that, in the treatment of inflammatory rheumatic disorders, advantage should be taken of the longer duration of action of ketoprofen suppositories to prescribe their administration early in the morning and before retiring. Local intolerance occurred in only 4 of 52 patients.

[Lymphoblast transformation test in osteoarticular tuberculosis].

Bacteriological proof of an osteoarticular tuberculous lesion is difficult to obtain, notably in Pott's disease. The authors, on the basis of earlier work in the field of pulmonary pathology, wished to assess the value of the lymphocyte transformation test in the diagnosis of this disease. Old tuberculin from the Pasteur Institute and LP48 tuberoulin were used at different concentrations.