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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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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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.