Long-term efficacy and safety of antitumour necrosis factor alpha treatment in rhupus: an open-label study of 15 patients.

Background: The efficacy of antitumour necrosis factor alpha (anti-TNF-α) treatment is well recognised in rheumatoid arthritis (RA) but remains controversial in systemic lupus erythematosus (SLE). Therefore, the role of anti-TNF-α treatment in 'Rhupus', a disease sharing features of RA and SLE, is still debated.

Objective: To evaluate the efficacy and tolerance of anti-TNF-α in patients with rhupus.

Pitfalls in osteoarticular imaging: how to distinguish bone infection from tumour?

In this article examining pitfalls in osteoarticular imaging we examine the differential diagnosis of osteomyelitis from bone tumours. We describe the different features which differentiate these two types of disease in radiology and CT and MRI scanning.

Intercostal myositis ossificans misdiagnosed as osteosarcoma in a 10-year-old child.

Myositis ossificans (MO) is a rare benign cause of heterotopic bone formation within soft tissue. It most commonly affects adolescents and young adults, typically in the limbs and following trauma. Very few cases have been reported in children.

[Acute, hyperintense, and febrile cervicalgia. Crowned dens syndrome, a monofocal microcrystalline arthritis sometimes doubly misleading].

Microcrystalline arthritis sometimes have atypical localizations and presentations. The crowned dens syndrome, due to hydroxyapatite or calcium pyrophosphate deposits in peri-odontoid ligaments of the atlas, can provoke acute or chronic cervicalgia or misleading presentations such as meningitidis or fever of unknown origin. We present a particularly severe new case requesting urgent surgery, and a literature review to alert clinicians and prevent misdiagnosing this syndrome.

Iliac bone defects revealing systemic sarcoidosis.

Bone lesions are fairly uncommon in sarcoidosis (5 to 10% of cases). We report the case of a 40-year-old man in whom sarcoidosis of the lungs and bones was revealed by excruciating buttock and sacral pain. Computed tomography showed multiple punched-out defects in the left iliac bone.

[Drug-induced osteopathies].

Several drugs can induce bone disorders. Steroid-induced osteoporosis is the best known of all drug-induced bone disorders. However, bone disorders have also been described in association with newer drugs (LH-RH analogs, retinoids, cyclosporine, etc.

[Treatment of osteoid osteoma using laser photocoagulation. Apropos of 28 cases].

Unlabelled: THE PURPOSE OF THE STUDY was to evaluate interstitial laser photocoagulation for local destruction of osteoid osteoma, with computed tomographic (CT) guidance.

Material And Methods: 28 patients (age range from 5 to 48 years) with presumed osteoid osteoma were treated with CT-guided interstitial laser photocoagulation of the nidus. A high power semiconductor diode laser (805 nm) with a 400 microns optical fiber was used.

[Epiphysis-metaphysis bone ischemia in hemorrhagic rectocolitis and Crohn's disease].

Aseptic osteonecrosis is a rare extraintestinal manifestation in patients with inflammatory bowel disease; its true prevalence is not precisely known. Steroid treatment undoubtedly participates in the pathophysiology of avascular osteonecrosis, however, other factors like hypercoagulability may be involved. Two cases of bilateral osteonecrosis of the knees--the first occurring during the course of ulcerative colitis, the second in a patient presenting with Crohn's disease--are described.

Interstitial laser photocoagulation of osteoid osteomas with use of CT guidance.

Purpose: To evaluate interstitial laser photocoagulation (a minimally invasive percutaneous technique of thermal destruction of deep-seated tumors, with low-power laser energy) in local destruction of osteoid osteoma, with computed tomographic (CT) guidance.

Materials And Methods: Fifteen patients (age range, 8-48 years) with presumed osteoid osteoma were treated with CT-guided interstitial laser photocoagulation of the nidus. A high-power semiconductor diode laser (805 nm) with a 400-microm optical fiber was used.

[Chronic recurrent multifocal osteomyelitis. A diagnosis to be called to mind].

Chronic recurrent multifocal osteomyelitis is a rare disorder that affects children and teenagers. Clinically, it is characterized by insidious onset of local swelling and pain in several metaphyses. A symmetric, recurrent and multifocal pattern is usual.

Percutaneous Laser Photocoagulation of Osteoid Osteomas.

Osteoid osteoma is a painful benign bone tumor. The curative treatment of this tumor consists of complete surgical or percutaneous excision of the nidus with immediate and dramatic relief of symptoms. Interstitial laser photocoagulation (ILP) is a low-invasive percutaneous technique of thermal destruction (coagulation) of deep-seated tumors elsewhere in the body, using low-power laser energy.

[Scaphoid fissure in algodystrophy: diagnostic value of MRI].

Stress fractures are exceptional in patients with reflex sympathetic dystrophy syndrome, even when bone loss is severe. We report a case of stress fracture of the navicular bone documented by magnetic resonance imaging. Recurrence of localized pain in patients with reflex sympathetic dystrophy syndrome suggests either a relapse of the syndrome or a bony fissure.

[Infectious osteoarthritis of the pubis in sportmen. Apropos of 2 cases].

In athletes, osteoarthritis of the symphysis pubis is an uncommon condition that should be promptly differentiated from pubic pain due to microtrauma. The symphysis pubis is infected via the bloodstream, usually by a staphylococcus. Pubic pain with fever and severe disability suggests the diagnosis.

[Pseudotumoral aspect of stress fracture of the pubis].

Stress fractures of the symphysis pubis are usually due to bone insufficiency. After describing two cases which caused diagnostic difficulties, the authors relate how these fractures may simulate tumor with deceptive bone destruction. The existence of predisposing factors, namely post-menopausal osteoporosis and a history of pelvic radiation therapy, together with the radiological characteristics associating bone destruction with peripheral sclerosis suggest the diagnostic.

[Post-traumatic and symptomatic lumbar intertransverse process bone bridge. Apropos of a case: review of the literature].

Osseous bridging of lumbar transverse processes is very seldom seen. A review of the literature has revealed only thirty-six reports. The first cases were thought to be of congenital origin.

[Lesions of the rotator cuff and acromioclavicular joint. Data of arthrography. Apropos of 2 cases].

Arthrography using an opaque medium to explore the shoulder in two cases demonstrated rupture of the rotator muscles sheath associated with a communication into the acromioclavicular joint. Rupture of the sheath allows direct contact between the humeral head and the capsule of the acromioclavicular joint which becomes eroded progressively. Recent studies have produced data indicating participation of the acromioclavicular joint in the natural history of deteriation of the sheath of the rotator muscles.