RESUMO
We report a new case of polyostotic fibrous dysplasia (FD). A 26-year-old woman was referred to our department complaining of pain in her left arm. She had suffered for tow fractures in left leg and arm previously. Plain radiographs showed osteolytics lesions at the left humerus and radius. Histological examination of the surgical specimens showed FD. She has beneficed with zoledronic acid perfusion.
Assuntos
Displasia Fibrosa Poliostótica/diagnóstico por imagem , Úmero/diagnóstico por imagem , Rádio (Anatomia)/diagnóstico por imagem , Adulto , Conservadores da Densidade Óssea/uso terapêutico , Difosfonatos/uso terapêutico , Feminino , Displasia Fibrosa Poliostótica/tratamento farmacológico , Displasia Fibrosa Poliostótica/patologia , Humanos , Úmero/patologia , Imidazóis/uso terapêutico , Radiografia , Rádio (Anatomia)/patologia , Ácido ZoledrônicoRESUMO
A 27-year-old-man was diagnosed as having ankylosing spondylitis (AS) in 2003 and received a treatment by etanercept. Typical symptoms of active Crohn's disease (CD) developed 11 months after initiation of etanercept therapy. At colonoscopy, lesions compatible with CD were found endoscopically and histologically. Etanercept was interrupted and CD responded to standard treatment. A switch to infliximab was decided to treat a flare up ofAS. New onset CD may be considered an immune mediated injury induced by etanercept, but the causative role of the latter has not been demonstrated at this stage.
Assuntos
Doença de Crohn/induzido quimicamente , Imunoglobulina G/efeitos adversos , Fatores Imunológicos/efeitos adversos , Adulto , Anticorpos Monoclonais/uso terapêutico , Colonoscopia , Etanercepte , Humanos , Imunoglobulina G/uso terapêutico , Fatores Imunológicos/uso terapêutico , Infliximab , Masculino , Receptores do Fator de Necrose Tumoral/uso terapêutico , Espondilite Anquilosante/tratamento farmacológicoRESUMO
The purpose of this report is to describe the case of a 13-year-old boy presenting typical sciatica leading to the discovery of primary pelvic hydatid cyst extending to the ischiatic bone. Diagnosis was suspected based on echography and magnetic resonance imaging and confirmed by surgical exploration.
Assuntos
Equinococose/complicações , Ciática/parasitologia , Adolescente , Humanos , Masculino , Pelve , TunísiaRESUMO
Tabetic arthropathy (TA) is a type of neuropathic arthropathy that has become rare. The purpose of this report is to describe a case of tabetic arthropathy involving the knee. A 53-year-old man was hospitalized for painless right knee arthropathy. Clinical examination demonstrated hydarthrosis of the right knee, peripheral neuropathic syndrome of the lower limbs, and paralysis of the IXth and Xth cranial pairs. Plain radiography showed the presence of lytic lesions in the internal femoral condyle and tibial plateau. Syphilitic serology tests were positive in the blood and cerebrospinal fluid.
Assuntos
Artropatia Neurogênica/diagnóstico , Tabes Dorsal/diagnóstico , Artropatia Neurogênica/microbiologia , Humanos , Articulação do Joelho/patologia , Masculino , Pessoa de Meia-Idade , Tabes Dorsal/complicações , TunísiaAssuntos
Lúpus Eritematoso Sistêmico/complicações , Espondilite Anquilosante/complicações , Adulto , Artralgia/etiologia , Feminino , Predisposição Genética para Doença , Humanos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/genética , Articulação Sacroilíaca/patologia , Espondilite Anquilosante/tratamento farmacológico , Espondilite Anquilosante/genética , Resultado do TratamentoAssuntos
Eosinofilia/etiologia , Fasciite/etiologia , Lúpus Eritematoso Sistêmico/complicações , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Humanos , Lúpus Eritematoso Sistêmico/fisiopatologia , Prednisona/administração & dosagem , Prednisona/uso terapêutico , Síndrome , Adulto JovemAssuntos
Artrite Reumatoide/metabolismo , Proteína Ligante Fas/metabolismo , Osteoartrite do Joelho/metabolismo , Líquido Sinovial/metabolismo , Receptor fas/metabolismo , Idoso , Apoptose/imunologia , Artrite Reumatoide/etiologia , Artrite Reumatoide/patologia , Biomarcadores/metabolismo , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/patologia , Membrana Sinovial/metabolismo , Membrana Sinovial/patologia , TunísiaRESUMO
Sweet's syndrome (SS) is an acute neutrophilic dermatosis characterised by abrupt onset of fever, leukocytosis and cutaneous eruption, with dermal neutrophilia on skin biopsy. Most cases are idiopathic but SS can be associated with various affections, especially neoplastic, inflammatory and infectious diseases. The authors report the case of an SS occurring in a patient with a known rheumatoid arthritis associated with a secondary Sjögren's syndrome, with incidental finding of concurrent lymph node tuberculosis. In case of SS, an associated disease (malignant, inflammatory or infectious diseases) must imperatively be searched for, knowing that two or more of these affections can coexist.
Assuntos
Artrite Reumatoide/complicações , Síndrome de Sjogren/complicações , Síndrome de Sweet/etiologia , Tuberculose dos Linfonodos/complicações , Adulto , Feminino , HumanosRESUMO
Hydatidosis, also known as echinococcosis, is a rare but serious parasitic disease in endemic areas. Primary spinal location is extremely rare. This case report describes a rare instance of hydatid cyst that caused severe and progressive low-back pain and neurologic dysfunction. Spine MRI showed a unique vertebral collapse of Th12 body with multicystic lesions filling the spinal canal. In addition, hydatidosis serodiagnostic test was positive at 1/725. Treatment depended on the actual surgical removal of the cysts. Surgery consisted in excision and extirpation of the cysts, associated with decompressive laminectomy. The diagnosis was confirmed on the basis of histological results. No coincidental hydatid visceral involvement was found. Antihelminthic drugs (Albendazole) were promptly given before surgery for a long period. The outcome was satisfactorily marked by total regression of the motor deficit and sphincter disorders.
Assuntos
Equinococose/diagnóstico , Fraturas por Compressão/etiologia , Dor Lombar/etiologia , Fraturas da Coluna Vertebral/etiologia , Vértebras Torácicas/lesões , Equinococose/complicações , Fraturas por Compressão/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fraturas da Coluna Vertebral/diagnósticoRESUMO
Brucellosis is a zoonosis that affects several organs. The spine is the most common site of musculoskeletal involvement. However, multiple-level spinal involvement is rare in brucella spondylodiscitis. The authors report a case of a 56-year-old male shepherd who had developed a spondylodiscitis affecting simultaneously the cervical, thoracic and lumbar regions. The diagnosis was established by using MRI after the brucella-agglutination test was found to be positive. A high degree of suspicion in the diagnosis of brucellar spondylodiscitis is essential to reduce the delay for the treatment. Thus, it should be essentially included in the differential diagnosis of longstanding cervical, thoracic or back pain, particularly in regions where brucellosis is endemic. Screening serological tests for brucella should be used more widely in cases with low index of suspicion, especially in endemic areas.
Assuntos
Brucelose/diagnóstico , Vértebras Cervicais , Discite/microbiologia , Vértebras Lombares , Imageamento por Ressonância Magnética , Vértebras Torácicas , Brucelose/complicações , Discite/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Spinal fractures in patients with ankylosing spondylitis may be the result of minor trauma. These fractures may lead to severe neurological deficits, and they are difficult to detect using standard radiography. Often, CT-scans and MRI are required for diagnosis.