[Abdominal pain and fever with urinary symptoms]. / Douleur abdominale fébrile associée à des signes urinaires.

A man consults for abdominal pain and fever. The diagnosis is suspected on a plain abdominal radiograph.

Un homme consulte pour des douleurs abdominales et une fièvre. Le diagnostic est évoqué sur une radiographie de l'abdomen sans préparation.

[Risk factors associated with osteoarthritis of the knee in a rheumatology outpatient clinic in Ouagadougou, Burkina Faso]. / Facteurs de risque associés à la gonarthrose en consultation de rhumatologie à Ouagadougou (Burkina Faso).

The purpose of this transverse prospective study was to assess risk factors associated with osteoarthritis (OA) of the knee observed in a rheumatology outpatient clinic in Ouagadougou, Burkina Faso. All patients presenting osteoarthritis of the knee diagnosed according to the clinical and radiological criteria of the American College of Rheumatology (ACR) were recruited over a 9-month period from November 2006 to July 2007. A total of 118 patients including 108 women were studied. Mean patient age was 55.7 +/- 10.8 years. Pain and disability scores assessed using theLequesne index were greater than 8 in 87.3% of patients. Hydarthrosis was observed in 56.5% of patients. The most common associated risk factors for development of osteoarthritis of the knee were obesity (42.4%), menopause in women (66.7%), history of OA (43.2%), and previous knee injury (19.5%). The most common associated risk factors for progression of osteoarthritis of the knee were Heberden nodes (19.5%) and genu varum (52.5%). The risk factors for development and progression of osteoarthritis of the knee in the subsahalian population of Ouagadougou are the same as in the Caucasian population of industrialized countries. An unexpected finding in this black African population was the high prevalence of Heberden nodes.

Inflammatory lumbar radiculalgia in Ouagadougou: posterior facet arthritis due to tuberculosis.

Posterior facet arthritis is rarely described. The authors report a case of arthritis of the posterior lumbar facet in a woman consulting for back pain associated with relative functional impairment. Modern imaging, in slices, enables better examination of the posterior arch and better diagnosis of pathologies. Tuberculosis is one of the conditions affecting the posterior lumbar facet, and its characteristics on MRI are well-defined. This case shows that tuberculosis is a not uncommon cause of posterior facet arthritis and should be considered even before the appearance of clinical and bacteriological signs to avoid catastrophic situations for the patient.

[Radiographic and ultrasonographic diagnosis of a left thoracic mass]. / Diagnostic radiologique et échographique d'une masse thoracique gauche.

A chest roentgenogram of a 69-year-old man undergoing a check-up before prostate surgery showed a mass in the antero-inferior zone of the lung, just above the diaphragm. At ultrasonography, it was considered to be a thoracic ectopic kidney. This radiological case illustrates the place of this anomaly in the differential diagnosis of lung solitary mass, which can be explored with ultrasonography when retroperitoneal herniation is suspected.

[Myocardial localization of a disseminated cysticercosis. Echocardiographic diagnosis of a case]. / Localisation myocardique d'une cysticercose disséminée. Diagnostic échocardiographique d'un cas.

Cysticercosis (cysticercus cellulosoe) is a parasitic infestation of human by a larval form of Taenia solium. The localisations are mostly the central nervous system, skeletal muscles and subcutaneous tissue, but other organs can be concerned. Myocardial cysticercosis is an extremely rare infection. We report a case of myocardial cysticercosis in a 37 year old patient who presented a disseminated form. The myocardium involvement is diagnosed by echocardiography. The clinical and echographic evolution was favourable after a treatment with albendazole. The other cardiovascular manifestations described in the literature are discussed.

[Radiography and ultrasonography in the management of bladder tumors: 71 cases at the National Hospital Center of Yalgado Ouedraogo (Burkina Faso)]. / Radiographie et échographie dans la prise en charge des tumeurs de la vessie: à propos de 71 cas au Centre hospitalier national Yalgado Ouedraogo (Burkina Faso).

The bladder's cancer is frequent in West Africa. Urinary schistosomiasis endemicity helps to explain this high incidence. It is a pathology of late diagnosis, little or badly explored by imaging. Through a retrospective survey of 71 patients' files aged in average of 51.7 years, all having a bladder's tumour which is clinically shown by an haematuria, the major symptom, often by a pelvic volume, and who have all gone through an abdominal echography and/or intravenous urography (IVU) and/or retrograde urethrocystography (UCR), we have tried to point out the role of imaging in the caring of this pathology in our working context. Imaging, with a 98.5% sensibility for sonography and 100% for IVU, took part in all the cases to the diagnosis, to the search of urinary signs of reflux, associated signs authorizing a diagnostic orientation, but was excluded from the evolutive follow-up due to the poverty of our populations. So, despite some limits specific to the survey, particularly the absence of historadiological comparison for all the files, echography and IVU with cystography have always led to malignancy diagnosis. Therefore they should be requested for any patient consulting for haematuria.

[Contribution of Abdoscan in MRI cholangio-pancreatography and MRI urography]. / Apport de l'Abdoscan en cholangio-pancréatographie par IRM et en urographie par IRM.

MR Cholangiopancreatography (MRCP) and MR Urography (MRU) are promising recent imaging modalities. Oral magnetic particles (Abdoscan, Nycomed SA, Oslo, Norway) is an oral negative contrast agent eliminating signal intensity of the gastro-intestinal tract thus improving image quality at MRCP and MRU.

[Non-Hodgkin lymphoma as a cause of intra-hepatic periportal low attenuation at computed tomography]. / Le lymphome malin non-hodgkinien est une cause d'hypodensité péri-portale intra-hépatique au scanner.

The authors report two cases of non-Hodgkin lymphoma in non immunodeficient subjects characterized by periportal low attenuation at CT. Both patients showed gallbladder wall thickening. The different causes of periportal abnormalities are presented and discussed.

[Ultrasound foetal biometry in the town of Ouagadougou, Burkina Faso. Report of a cohort of 126 pregnant women]. / Biom¿etrie foetale ultrasonore dans la ville de Ouagadougou, Burkina Faso. A propos d'une cohorte de 126 gestantes.

PURPOSE: This inquiry on the ultrasound fetal biometry in the town of Ouagadougou aimed to study the fetal growth through the ultrasound biometry in order to compare it with other authors's works and to lay down a local chart. PATIENTS AND METHODS: This prospective study led from March 1997 to April 1998 The follow-up of 126 pregnant women allowed to lay down the graphs of following elements: biparietal diameter, cephalic circumference, transverse abdominal diameter, abdominal circumference and femur. RESULTS: The average age of the subjects was 26 years old+/-0.8 and 52.4% of them belonged to an average socio-economic level. All the studied parameters were closely connected with the age of pregnancy. The DAT and the abdominal circumference presented the greatest correlation (0.998). The comparison of our growth graphs with those of others authors led to notice significant differences as well as with African, European and American graphs. CONCLUSION: There is a need to lay down local charts in order to have a best estimation of the pregnancy age and the fetal growth.

[Features of hysterosalpingography performed in Burkina Faso]. / Particularités des hystérosalpingographies réalisées en milieu Burkinabé

PURPOSE: The goal of this study was to describe the distinctive hysterosalpingographic features of women with infertility in Burkina Faso. MATERIALS AND METHODS: We performed a retrospective study of 1019 women who were referred for infertility between January 1996 to June 1997 at the National Hospital Centre of Ouagadougou. Clinical and radiological features were reviewed and statistical data analysed on the software EPI Info 5.0. RESULTS: The mean age of the patients was 28+/-0,3 years. Primary infertility was found in 34.4% and secondary infertility in 65.6%. Abnormalities on plain film were present in 6.9% of the cases. Hysterosalpingography was abnormal in 62.1% of the cases. Tubal abnormalities were found in 62% and uterine lesions in 38.3%. The main hysterosalpingographic abnormalities were tubal obstructions, hydrosalpinx, uterine fibromas, and trauma sequelae in 25,9%, 25,3%, 16,5% and 10% of cases respectively. Seventy one percent of tubal and uterine lesions represent outcomes of chronic infections and underground abortions. CONCLUSION: In Burkina Faso, hysterosalpingographic abnormalities are characterized by the predominance of infectious and traumatic sequelae. Such a frequency could be reduced by active politics against underground abortion and information about genital infections.

[Warm saline enema for reduction of intestinal invagination under the ultrasonographic guidance: preliminary results apropos of 2 cases]. / Désinvagination intestinale par lavement au sérum salé isotonique tiédi sous contrôle échographique: résultats préliminaires à propos de deux cas.

The authors describe the use of isotonic normal saline enema under US guidance in the treatment of acute uncomplicated intestinal intussusception in infants. The technique was successfully used in two patients aged respectively 18 and 16 months, with 11 and 9-month follow-up. The various steps of this technique and the results are analyzed and discussed. It is a valuable alternative to surgical treatment or hydrostatic reduction with opaque x-ray contrast under fluoroscopic guidance.

[A case of pneumopericardium complicating a liver abscess in a patient infected with HIV]. / Un cas de pneumopéricarde compliquant un abcès du foie chez un patient infecté par le VIH.

Pneumopericardium usually occurs in a traumatic context or, more rarely, in the course of benign or malignant bronchial or oesophagogastric diseases. Although the idiopathic spontaneous form is even rarer, pneumopericardium complicating liver abscess is exceptional, and is facilitated by impaired immune defenses (alcoholism, immuno-depression). The authors report a case of liver abscess complicated by pneumopericardium in an HIV seropositive patient. The nature of the abscess, the mechanism of the pneumopericardium and the therapeutic management are discussed.

[Primary pulmonary myxoid liposarcoma discovered fortuitously]. / Liposarcome myxoïde pulmonaire primitif de découverte fortuite.

We report a fortuitous discovery of primary pulmonary myxoid liposarcoma in an HIV-positive patient. Primary pulmonary localizations are uncommon. Generally, pulmonary localizations are metastatic. There is a male predominance and diagnosis is generally made around 40 years of age. The two main features of liposarcoma are the large tumor size and the complex histology that evolves over time. Pathology findings are rarely reproducible and vary from one pathologist to another. Macroscopically, liposarcomas can mimic benign tumors. The risk of recurrence is high after simple enucleation due to microscopic extracapsular extensions. Surgery remains the predominant treatment. Wide complete excision, if possible, provides long-term survival.

[Non-traumatic circumscribed myositis ossificans. Apropos of a bilateral localization]. / La myosite ossifiante circonscrite non traumatique. A propos d'une localisation bilatérale.

The authors report one case of a bilateral atraumatic circumscribed myositis ossificans (C.M.O.) developed from the triceps muscles with major equinism, in a 15 years old girl. One side presented a current tumor, the other was seen at the first episode. The authors obtained a good functional result after surgical treatment and advocate this treatment.

[Laryngo-tracheo-bronchial foreign bodies in children at the University Hospital Center of Ouagadougou (analysis of 96 cases)]. / Les corps étrangers laryngo-trachéo-bronchiques chez l'enfant au CHU de Ouagadougou (une analyse de 96 observations).

Over a 10-year period, a series 96 patients were treated for laryngotracheal and bronchial foreign bodies in the ENT department of the Ouagadougou University Hospital Center (Burkina Faso). The purpose of this study was to analyze the epidemioclinical features and therapeutic pitfalls encountered in that series and to propose measures to improve management. The age of patients ranged from 10 months to 14 years. The male-female ratio was 1.7. Anamnesis documented foreign body aspiration was obtained in 77% of cases. The foreign body was organic in 78 cases (81.2%) including vegetal material in 56 cases. Management was delayed due to late diagnosis since only 59.3% of the patients were admitted to the hospital within the 48 first hours. Endoscopic removal was performed in all cases but such procedures remain challenging in developing countries due to a lack of proper anesthetic facilities, skilled personnel and adequate equipment. Tracheostomy was performed in 10.4% of cases mainly in patients with foreign bodies located in larynx. One patient died during extraction. In addition to providing more information and education on prevention of laryngotracheal and bronchial foreign bodies, better management requires better training of medical personnel and improvement of technical facilities.

[Fetal weight gain curve for a cohort of 126 pregnant women at Ouagadougou, Burkino Faso]. / Courbe foetale de croissance pondérale à Ouagadougou (Bukina Faso). A propos d'une cohorte de 126 gestantes.

We carried out a prospective study at Ouagadougou, from March 1 1997 to April 30 1998, in which we plotted curves of fetal weight gain, estimated by ultrasound biometry, with the aim of comparing our results to those of other authors and establishing a local chart. We established a growth curve from 936 fetal weights estimated during the follow up of 126 pregnant women. The mean age of the women included was 26 +/- 0,8 years and 52.4% were of the mean socioeconomic level. We identified significant differences between our weight gain curve and those of other authors. The factors involved in this difference are unclear but may be nutritive, ecological and ethnic in nature. Further work is required to produce local charts, to optimize the estimation of fetal weight.

[Caseous pneumonia in a 14-month-old infant]. / Pneumonie caséeuse chez un nourrisson de 14 mois.

We report a case of caseous pneumonia in a 14-month-old HIV-negative infant. This clinical picture is usually observed in healthy young adults, rarely in infants. The clinical and radiological signs of caseous pneumonia often simulate acute non-tuberculous respiratory disease. Bacteriological confirmation is required, but the diagnosis can be suggested in case of a pulmonary syndrome with no bacterial isolate and unresponsive to well-conducted antibiotic therapy. The clinical course is rapid with caseous involution of the lung. Early diagnosis is required for specific curative treatment and to limit sequelae.

[Active tuberculosis in a patient with Hodgkin's disease. A case report]. / Tuberculose évolutive associée à une maladie de Hodgkin. A propos d'un cas.

We report a case of active tuberculosis in a patient with Hodgkin's disease. The two diagnoses were established simultaneously at the Respiratory Disease Unit of the Yalgado National Hospital, Burkina Faso. The clinical presentation was misleading as the signs and symptoms of the two disease are similar. Certain diagnosis was established after isolation of tuberculosis bacilli and histocytology findings for Hodgkin's disease. Both diseases are potentially curable. The clinical course depends on early diagnosis and treatment.

[Contribution of ultrasonography in the pathology of the scrotum and its contents]. / Apport de l'Echotomographie dans la pathologie du scrotum et de son contenu.

Echography must, henceforth, be considered a method of investigation in Scrotum pathology. It is certainly of interest for diagnosis and close supervision of this pathology--this is the recommendation of the authors following 46 observations correlating echographical aspects with anatomopathological results.