[Cauda equina syndrome and ankylosing spondylitis. Association with acromegaly. A myelographic and tomodensitometric study of the lumbar canal]. / Syndrome de la queue de cheval et spondylarthrite ankylosante. Association à une acromégalie. Etude myélographique et tomodensitométrique du canal lombaire.

Cauda equina syndrome is a rare neurological complication of ankylosing spondylitis. The specific myelographic and tomodensitometric anomalies are exemplified by the reported observation. This case is unusual by the moderation of the neurological manifestations, and especially by the absence of sphincteral disorders. The characteristic roentgenologic signs of ankylosing spondylitis are associated with a scalloped appearance of the lumbar spinal column and antecedent quiescent acromegaly.

[Acute leukaemias after treatment using cytotoxic agents for rheumatological purpose. 19 cases among 2006 patients(author's transl)]. / Leucémies aiguës après traitement par agents cytotoxiques en rhumatologie. 19 observations chez 2006 patients.

The authors undertook a retrospective study to determine the number of acute leukaemias developing amongst 2006 patients suffering from chronic inflammatory rheumatic conditions and connective tissue disorders, treated with cytotoxic agents. The follow-up period ranged from 1 to 13 years. Nineteen leukaemias were found, essentially granulocytic, with a latent period of 5.7 +/- 2, 8 years after the beginning of treatment. This incidence of almost 1% of leukaemias is probably less than the actual percentage since a number of patients were lost on follow up and since the period of observation is as yet too short. The majority of patients has been treated for more than one year. No cases were seen amongst patients treated for less than six months, or with less than 1g of chlorambucil or 50 g of cyclophosphamide. The risk would seem to be the same for both alkylating agents. No patients treated with azathioprine developed leukaemia, but few patients received this drug. Amongst 35 patients treated for severe psoriatic arthropathy with chlorambucil, 4 developed leukaemia. This particularly high percentage is such that all trials of alkylating agent in this condition should be stopped. The prevalence of leukaemia seen in the series as a whole is comparable to that found in mass studies carried out in various malignant diseases treated by cytotoxics. Awareness of this risk should, lead to even stricter limitations before the use of cytotoxic drugs in rheumatological conditions.

[A special form of lupus disease. Deep cutaneous lupus. Apropos of 2 cases]. / Une forme particulière de la maladie lupique; le lupus cutané profond. A propos de deux observations

Deep cutaneous lupus is a clinical form of lupus disease for which a very old description has recently been brought up to date. Two new cases are reported here and a review of the literature makes it possible to analyse the clinical, biochemical, histological, and immunological features of this panniculitis. Different from the Weber-Christian syndrome, it is characterized by repeated eruptions of nodules and/or subcutaneous plaques, and histologically by vasculitis, lymphocyte infiltration, and sometimes te presence of immunoglobulins on the basal dermal membrane and around the vessels.

[Arthrotic sciatica caused by radicular compression of osteophytic origin in the lateral recess. Apropos of 18 cases]. / Sciatiques "arthrosiques" par compression radiculaire d'origine ostéophytique dans le récessus latéral. A propos de 18 observations

The authors report 18 cases of arthrosic sciatica due to toot compression in the lateral recess by posterior corporeal and/or posterior apophyseal osteophytosis. The authors study the clinical and radiological characteristics that may indicate the diagnosis and discuss the different mechanisms by which vertebral arthrosis can lead to radicular compression. When surgery is necessary because of the persistent nature of the sciatica, a broader approach should be undertaken than that required for excision of the disc, in order to explore fully the roots, the multiplicity of possible compression sites being one of the essential characteristics of these cases of arthrosic radiculopathy. Study of the literature and of the series of sciatica patients operated upon by the authors shows that although discal hernia is far from being the most frequent cause of common sciatica, arthrosic compression is a cause that cannot be ignored, especially in aged subjects.

[Degenerative spondylolisthesis. Clinical manifestations and treatment apropos of 26 operated cases]. / Spondylolisthésis dégénératif. Manifestations cliniques et traitement à propos de 26 cas opérés

The authors report 26 cases of surgically treated degenerative spondylolisthesis. Twelve patients complained of permanent uni or bilateral sciatica. All the others had a syndrome of intermittent claudication with pain and paresthaesia. The authors stress once again the highly evocative nature of this syndrome which reflects involvement of the nerve roots in the stenosed lumbar canal. Treatment consisted of lamino-arthrectomy which resulted in the disappearance of symptoms in most of cases. In four cases, vertebral slipping worsened during the post-operative cowise with, in three cases a recurrence of symptoms necessitating a complementary arthrodesis. This risk of increased slipping is a result of the instability created by the arthrectomy, especially when it is bilateral, and has led the authors to widen their indications for routine complementary postero-lateral arthrodesis.

[Benign giant cell tumors associated with Paget's disease. Apropos of 1 case]. / Tumeurs bénignes a cellules géantes associées a une maladie de paget

The authors report the observation of two benign giant-cell tumours that developed in the cranium of Paget's disease patients. The two tumours were resected and cure was complete. Eighteen other cases of benign giant-cell tumours were found in the literature. All were discovered in relation to tumefaction occurring in an affected bone in a patient with generalized Paget's disease, often unrecognized. The tumours were usually unique although multiple tumours were found, with particular predilection for the bones of the cranium and the face. The radiological signs consisted of an osteolytic zone in an affected bone; there were no specific characteristics and it was not possible to distinguish the tumours from a malignant tumour. Diagnosis was based upon an anatomo-pathological examination. In the 18 cases in the literature, the benign caracter indicated by the biopsy was confirmed by the favourable evolution. In contrast in 17 other cases the atypical nature of the stroma, the irregular arrangement of the giant cells together with the occurrence of atypical mitoses and the abnormal character of the vascularization indicated straight away the malignant nature of the lesions, which was regularly and rapidly fatal.