Revue du rhumatisme (English ed.)
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Review Case Reports
Acute neck pain and fever as the first manifestation of chondrocalcinosis with calcification of the transverse ligament of the atlas. Five case-reports with a literature review.
We report five cases of acute neck pain with fever in patients with diffuse articular chondrocalcinosis and computed tomography evidence of calcification of the transverse ligament of the atlas. A review of the relevant literature illustrated the high frequency of this condition, the variability of clinical presentations ranging from episodes of acute neck pain with fever to compression of the proximal spinal cord, the value of computed tomography for determining the site of the calcific deposits and assessing the lesions, and the possibility of deposition of both calcium pyrophosphate dihydrate and hydroxyapatite crystals in the same patient.
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Acrodermatitis chronica atrophicans is a delayed manifestation of Lyme disease caused by a Borrelia burgdorferi subspecies, B. afzelii. Although rheumatic manifestations are rare, they can result in deformities of the fingers and toes if they are not treated promptly. ⋯ The diagnosis of acrodermatitis chronica atrophicans rests on a history of a tick bite, a suggestive skin biopsy histology and a positive Western blot for B. afzelii. A positive response to antimicrobial therapy is also required. Acrodermatitis chronica atrophicans, a common condition in central and northern Europe, can cause joint manifestations and persistent finger deformities in the absence of early treatment.
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Comparative Study
Prospective study of the prevalence of bronchiectasis in rheumatoid arthritis using high-resolution computed tomography.
A prospective study of the prevalence of bronchiectasis in rheumatoid arthritis was conducted over an 18-month period in 46 patients (34 women and 12 men with a mean age of 60.1 years) meeting 1987 American College of Rheumatology criteria for rheumatoid arthritis. All patients underwent high-resolution computed tomography of the chest, whose results were confronted with a number of clinical, laboratory test and lung function testing parameters. Bronchiectasis or bronchiolectasis was found in 23 patients (50%) and was the most common abnormality detected by high-resolution computed tomography. ⋯ Among the patients with bronchiectasis, those with respiratory symptoms (n = 10) were more likely to have a history of lung disease and those without respiratory symptoms (n = 13) were more likely to have a diagnosis of bronchiectasis secondary to rheumatoid arthritis; no other differences were found between these two subgroups. Routine use of high-resolution computed tomography, a technique capable of demonstrating silent bronchiectasis, showed that bronchiectasis was the most common lung change in rheumatoid arthritis in our study. At the time of the study, there was no evidence that presence of bronchiectasis was associated with more severe joint or lung symptoms.
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Clinical Trial
Short-term evaluation of periradicular corticosteroid injections in the treatment of lumbar radiculopathy associated with disc disease.
The purpose of this study was to evaluate the feasibility and efficacy of periradicular corticosteroid injections performed under fluoroscopic guidance in the treatment of pain originating in the lumbosacral nerve roots. ⋯ Periradicular injections of corticosteroids done under fluoroscopic guidance as an outpatient procedure was effective and safe in our study and may deserve to be used as part of the conservative management of lumbar nerve root pain before resorting to more invasive methods.