Revue du rhumatisme (English ed.)
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Review Case Reports
Multiple rheumatoid bursitis with migrating chylous cysts. Report of a case in a European woman and review of the literature.
We report a case of recurrent multiple bursitis (19 episodes at nine sites) requiring seven surgical procedures in a European women with a 38-year history of severe, nodular, destructive seropositive rheumatoid arthritis unresponsive to second-line drugs. The episodes of bursitis were not correlated with activity of the joint disease. Some cysts migrated over a considerable distance. ⋯ The histologic study of one cyst demonstrated a cholesterol crystal granuloma. Potential relationships linking cholesterol crystals, chylous cysts, and migrating multiple bursitis are discussed. The relevant literature is reviewed.
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Review Comparative Study
Efficacy of epidural steroids in low back pain and sciatica. A critical appraisal by a French Task Force of randomized trials. Critical Analysis Group of the French Society for Rheumatology.
Several randomized trials have suggested recently that epidural steroid injections may not be a valid treatment in common low back pain and sciatica. To clarify this issue, we conducted a critical appraisal of relevant randomized trials published up to 1997. Attention was directed to methodological quality, results, and clinical implications. ⋯ Whether epidural steroids are effective in common low back pain and sciatica cannot be determined based on our review.
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Clay-shoveler's fracture is a fatigue fracture of a lower cervical or upper thoracic spinous process. This occupational injury occurs primarily in workers who shovel heavy loads for long periods of time. ⋯ A review of clay-shoveler's fracture is presented. Emphasis is put on the legal aspects that can raise problems for rheumatologists, radiologists, occupational physicians and physicians performing expert evaluations of patients filing compensation claims.
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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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Review Case Reports
Can an osteoporotic vertebral fracture cause compression of the spinal cord or cauda equina.
A 78-year-old woman developed an osteoporotic fracture of L2 followed two months later by spinal cord compression. Imaging study findings suggested a malignancy but a biopsy showed osteonecrosis, of which there was no evidence on the imaging studies. Osteonecrosis may be the cause of neurologic compromise associated with osteoporotic vertebral fractures.