Joint, bone, spine : revue du rhumatisme
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Peripheral nerves disorders are common in the rheumatologic practice and can mimic a variety of musculoskeletal diseases. Clinical evaluation remains the mainstay for diagnosing nerve disorders of the extremities. A careful history and an accurate physical examination lead in most patients to a high diagnostic suspicion. ⋯ Well recognized advantages of this technique in this field are: the possibility of realizing a dynamic examination and assessing long nerves segments in a short time; it is non-invasive and low cost. In addition US is better accepted by the patients. In this article we present a brief description of the normal and US anatomy of the peripheral nerves followed by a description of the US appearance of the most frequent disorders: entrapment neuropathies (EN), tumor and cystic lesions.
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The aim is to describe the characteristics of osteoporotic pelvic fractures and their outcome. We recorded clinical and biological characteristics of 60 osteoporotic pelvic fractures hospitalized in our Department of Rheumatology and assessed their outcome in 51 cases, using a questionnaire administrated by phone call. In our population, pelvic fractures mainly affected elderly women (81.6% of women, mean age 79 years), presenting, in more than 50% of the cases, a past medical history of osteoporosis, previous fracture and cardiovascular disease. ⋯ Among living patients, 74.5% lived at home, 60% required assistance for at least one daily life activity and 18.6% experienced a new fracture. Only 63.2% were still treated for osteoporosis. Osteoporotic pelvic fractures requiring initial hospitalization share most characteristics of hip fracture: elderly people, women predominance, vitamin D insufficiency, fall triggering the fracture, and also the severity assessed by a high morbidity and mortality and loss of autonomy.
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To determine the prevalence of ossification of the posterior longitudinal ligament (OPLL) in cervical spines in Koreans. ⋯ The prevalence of cervical OPLL in Koreans was 0.60%, which was lower than that of Japanese and some previous western reports.
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In patients with symptoms caused by intervertebral disk displacement, studies of epidural corticosteroid injections have produced compelling evidence of a short-term analgesic effect (lasting about 3 weeks), despite a number of discrepancies. In contrast, no reductions were noted in the time off work or need for surgery. Strong evidence supports a short-term symptomatic effect of guided transforaminal corticosteroid injections, and there is also some evidence of a long-term effect. ⋯ Intradural injections should not be performed, as they may induce adverse effects and have not been proved effective. Interspinous injections and iliolumbar ligament injections can be considered in selected patients. Although published data have led to controversy about the effectiveness of local corticosteroid injections, a short-term analgesic effect is usually obtained, making this modality useful for the second-line treatment of patients with disk-related sciatica, as well as in selected patients with chronic low back pain.