[Correlation between detrusor thickness, intravesical prostatic protrusion and maximum urinary flow in the monitoring of benign prostatic hyperplasia]. / Corrélation entre épaisseur du détrusor, index de protrusion prostatique et débit urinaire maximal dans le suivi de l'hypertrophie bénigne de la prostate.

INTRODUCTION: Detrusor thickness (DT) and intravesical prostatic protrusion (IPP) are closely related to bladder outlet obstruction. The aim of our study was to look for correlation between DT, IPP and maximum urinary flow (Qmax). METHODS: It is a prospective, observational study including men over fifty managed for benign prostatic hyperplasia. Low urinary tract symptoms were assessed with the International Prostatic Symptom Score (IPSS). Pelvic ultrasound was performed for all patients measuring prostatic volume, bladder volume, post- void residual, DT and IPP. Uroflowmetry was performed for all patients, Qmax was noted. Qmax equal or less than 15ml/s was considered pathologic. RESULTS: Sixty patients were included for our study. Strong negative correlation was noted between DT, IPP and Qmax (r=-0.59, r=-0.61 respectively). Patients with pathologic Qmax had higher DT and IPP than those with normal Qmax, the difference was significant (P<0.01). Threshold values predicting pathologic Qmax were 3mm for DT and 7mm for IPP. ROC analysis reveals for DT an AUC of 0.84 (95% CI 0.76-0.92) and for IPP an AUC of 0.88 (95% CI 0.80-0.97). CONCLUSION: Detrusor thickness and intravesical prostatic protrusion have strong negative correlation with Qmax. These parameters could be an alternative to Qmax measurement if uroflowmetry is unavailable. LEVEL OF EVIDENCE: Grade B.

Ureteral tumor in an ectopic duplex system: a case report.

INTRODUCTION: Ureteral ectopia is a rarely observed anomaly. It may be totally asymptomatic. An association with a duplex system is exceptional. Diagnostic and therapeutic approaches are challenging. Carcinologic surgery must consider the anatomic variant, mainly related to the ectopic site of the ureteral orifice. OBSERVATION: We report a case of a ureteral urothelial carcinoma in a North African 52-year-old male patient, in a right duplex system. Radiological explorations concluded a non-functional upper right kidney. A suspect mass was observed in the lumbar part of the ureter of the right upper system. The meatus of the tumorous ureter ended in the right lobe of the prostate. A right hemi-nephro-ureterectomy was performed. A histological examination concluded a pT2G2 urothelial carcinoma. CONCLUSION: Even if malignancy is rarely observed in ureteral ectopia, it should be evoked mainly in cases of hematuria with risk factors for urothelial tumors.

[Prevalence of axial manifestations among patients with inflammatory bowel disease: a prospective study about 50 cases]. / Prévalence des manifestations axiales au cours des maladies inflammatoires chroniques de l'intestin: à propos d'une étude prospective de 50 cas.

BACKGROUND: Rheumatologic manifestations occurring during inflammatory bowel disease are the most frequent extra intestinal features. They are dominated by spondyloarthropathies, sacro-iliite and peripheral arthritis. AIM: To identify in a group of inflammatory bowel disease, the frequency of axial manifestations, to describe the clinical and the radiological features and to identify the risk factors of their occurrence and/or worseness. METHODS: We have established a transversal prospective study including 50 cases of inflammatory bowel disease seen in the department of the internal medicine in the interior forces security hospital during a period of 5 years between January 2001 and December 2006. RESULTS: The prevalence of axial involvement in the case of inflammatory bowel disease was 26% especially spondyloarthropathies which were diagnosed in 11 cases according to the criteria of European Spondyloarthropathy study Group (ESSG), 8 of them fulfilled the modified criteria of New York for the diagnosis of spondyloarthropathy. Isolated sacro-iliitis was found in 4% of cases. By univariate study, only the age under 35 years with a relative risk of 5,8 and the colic involvement in Chron's disease was significativelly associated with the presence of spondyloarthropathy. CONCLUSION: Systematic checking of spondyloarthropathies in the course of inflammatory bowel disease through a clinical exam and systematic radiological should be recommended especially if we are in front of a man aged more than 35-years-old with a Chron disease involving the colon. This screening offers an early management and avoid ankylosis.

[Spiral computed tomographic (CT) arthrography versus arthroscopy in internal derangements of the knee]. / Confrontation arthroscanner helicoidal-arthroscopie dans les dérangements internes du genou.

BACKGROUND: The spiral computed tomographic (CT) arthrography of the knee represents an alternative for MRI in the diagnosis of intraarticular lesions of the knee. METHODS: We compared, in our retrospective study relates to fifty knees presenting meniscal or anterior cruciate ligament or cartilage lesions, the data of spiral computed tomographic (CT) arthrography and arthroscopy taken as "Gold Standard". The purpose was to determine the reliability of the spiral CT arthrography in the diagnosis of intraarticular derangements of the knee. RESULTS: We found that sensibility and specificity of spiral CT tomography were respectively 86% and 81% for the detection of meniscal tears. They were respectively 60% and 86% for the detection of the cartilage lesions. The sensibility and specificity were respectively 47% and 94% for the detection of anterior cruciate ligament lesion. CONCLUSION: the spiral CT arthrography, with its submillimeter spatial resolution, was reliable in the diagnosis of the meniscal and cartilage lesions whereas its value in the diagnosis of the anterior cruciate ligament tears remains to be determined.

[Retroiliac ureter imaging. A case report]. / Apport de l'imagerie dans l'uretère rétroiliaque. A propos d'un cas.

The retroiliac ureter is a rare congenital anomaly with no specific clinical and biologic signs. The authors reports a case of right retroiliac ureter diagnosed in a 41-year-old male with an isolated renal colic. Diagnosis was confirmed by abdominal CT-scan. The different investigations did not show other associated congenital abnomaly. Therapeutic decision was to establish a clinical, biologic and sonographic surveillance.

[Imaging of neuro-Behcet]. / Apport de l'imagerie au cours des manifestations neurologiques de la maladie de Behcet.

Behcet's disease is a vasculitis affecting predominantly the venous system. It's characterized by a classical triad of recurrent uveitis, oral and genital ulceration. Behcet's disease is more frequent in Japan, the Middle East and some Mediterranean countries. Its pathogenesis is still uncertain. Neurological manifestations in Behcet's disease are not rare and are associated with poor prognosis. These manifestations can be inaugural in 5% of cases and they are polymorphous. We report 15 new cases of neuro Behcet's disease explored by magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA).