ABSTRACT
OBJECTIVE: To translate into Arabic and validate the "American Shoulder and Elbow Surgeons Evaluation Form" (ASES) for use in a Tunisian population presenting with periarticular pathologies of the shoulder. BACKGROUND: No functional index assessing the functional capacities of the shoulder is presently available in Arabic. PATIENTS AND METHODS: The translation was achieved by means of forward/backward translation. Adaptations were carried out subsequent to a preliminary test involving 15 persons. Patients with periarticular shoulder disabilities were included. Clinical measurements evaluated pain and functional disability by means of the visual analogue scale (VAS). Interrater concordance (repeatability) was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct validity (convergent and discriminant validity) was investigated using the Spearman rank correlation coefficient and a factorial analysis followed by orthogonal rotation. The internal consistency of each factor was graded in terms of the Cronbach alpha coefficient. RESULTS: Eighty (80) patients were included in the study. Interrater concordance was excellent (ICC=0.96). The Bland and Altman method showed a low-variability mean difference. Correlations of the index score with the pain VAS (r=-0.49) and functional disability (r=-0.58) suggested satisfactory convergent validity, and our index likewise showed good discriminant validity. Factorial analysis led to the extraction of two factors with a cumulative variance rate of 92.6% that could not be explained. CONCLUSION: Translated into Arabic, the ASES index was found to possess high metrological qualities. While the index has been satisfactorily validated with regard to a Tunisian population, additional studies are needed to verify its applicability to other Arab populations.
Subject(s)
Cultural Characteristics , Joint Diseases/physiopathology , Shoulder Joint , Surveys and Questionnaires , Adult , Aged , Female , Humans , Language , Male , Middle Aged , Pain Measurement , Tunisia , Young AdultABSTRACT
Bone hydatid disease is a rare pathology, characterized by its long clinical latency, the absence of radiological specificity as well as its challenging surgical treatment. We report an observation of pelvic bone hydatidosis in a 28-year-old patient, appearing with pain and stiffness of the hip as well as a degenerative aspect on the coxofemoral joint on X-ray. The treatment consisted of an extensive hemipelvectomy with femoro pelvic arthrodesis, completed by medical treatment. The functional result was excellent in spite of a break in the fixation material, which allowed a certain mobility at the proximal end of the femur. Hydatid disease of bone is infiltrating,diffuse, slow, and progressive, all characteristics explaining the often-delayed diagnosis. Medical imaging provides accurate analysis for planning a broad surgical resection. The quality of surgical resection is determined according to the risk of recurrence. Pelvic locations are particularly difficult to treat. After an enlarged and difficult surgical resection, reconstruction remains aleatory and poses many technical problems.
Subject(s)
Bone Diseases/parasitology , Bone Diseases/surgery , Echinococcosis/surgery , Adult , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Arthrodesis/methods , Bone Diseases/diagnosis , Bone Diseases/drug therapy , Bone Screws , Combined Modality Therapy , Diagnosis, Differential , Echinococcosis/diagnosis , Echinococcosis/drug therapy , Humans , Magnetic Resonance Imaging , Male , Reoperation , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES: To describe the epidemiological and clinical features of patients with primitive adhesive capsulitis of the shoulder treated by capsular distension and then rehabilitation; to evaluate the short-, mid- and long-term efficiency of this therapeutic protocol and compare it with rehabilitation alone. MATERIALS AND METHODS: This was a two-year prospective study. Sixty patients were included and divided into populations P1 (capsular distension and rehabilitation) and P2 (rehabilitation only). Assessment of the treatments' efficacy was based on the following parameters: pain on a visual analogue scale (VAS), joint motion in several axes, a simplified Constant score (functional ability) and the SF-36 quality of life score. RESULTS: Thirty patients (mean age: 56) underwent capsular distension. The Constant score was judged to be poor in over half of the patients. All the quality of life parameters were modified. When compared with P2, the P1 group showed a statistically significant improvement in terms of the pain score (p=0.005), anterior elevation (p=0.001), lateral elevation (p=0.005), external rotation (p=0.006) and the Constant score (p<0.001) one week after capsular distension. One year after capsular distension, this gain persisted in a statistically significant manner for all functional parameters and all SF-36 dimensions (p<0.001 for PF, RP, BP, SF and RE; p=0.01 for GH and VT and p=0.002 for MH). CONCLUSION: Our results show that capsular distension and subsequent intensive rehabilitation have a beneficial effect. This combination enables rapid, significant improvement from the first week onwards. The improvement phase lasts for one month and may hold steady for up to 12 months.
Subject(s)
Bursitis/therapy , Dilatation , Joint Capsule/surgery , Shoulder Joint , Anesthetics, Local/administration & dosage , Anesthetics, Local/therapeutic use , Bursitis/rehabilitation , Dilatation/methods , Female , Humans , Injections, Intra-Articular , Male , Middle Aged , Pain Measurement , Physical Therapy Modalities , Pregnatrienes/administration & dosage , Pregnatrienes/therapeutic use , Prospective Studies , Quality of Life , Severity of Illness Index , Shoulder Pain/drug therapy , Shoulder Pain/etiology , Sodium Chloride/administration & dosage , Sodium Chloride/therapeutic use , Treatment OutcomeABSTRACT
Introduction : Le mal de Pott est la localisation la plus frequente de la tuberculose osteo-articulaire. La localisation sous occipitale reste exceptionnelle. Observation : Enfant age de 12 ans; originaire de Sidi Bouzid; bien vaccine a consulte pour des cervicalgies et une dysphagie. L'examen clinique a revele un bombement de la paroi posterieure de l'oropharynx ainsi qu'une tumefaction basicervicale fistulisee a la peau. Une IRM du rachis cervical ainsi que le scanner cervico-thoracique ont objective une collection retro pharyngee associee a des adenopathies mediastinales necrosees et une lesion retractile pulmonaire lobaire superieure gauche. Le malade a eu une incision et drainage de l'abces retropharyngien en urgence. Le bilan biologique a objective une vitesse de sedimentation elevee a 112 a la premiere heure. L'IDR a la tuberculine etait negative mais le prelevement pour examen bacteriologique et recherche de BK etait positif. Le diagnostic de mal de Pott sous occipital associe a une localisation tuberculeuse pulmonaire a ete retenu. Le traitement anti-tuberculeux a ete maintenu pendant 11 mois avec une bonne evolution. Le recul est de 6 ans. Discussion : La localisation sous occipitale du mal de Pott est rare. Les cervicalgies constituent le motif de consultation le plus frequent. Cependant; la dysphagie et l'abces retropharyngien peuvent etre revelateurs. L'imagerie par resonance magnetique est necessaire afin d'evoquer le diagnostic de facon precoce. Le diagnostic de certitude se fait par la mise en evidence du bacille de Koch au niveau du foyer pottique. Le traitement est base sur la chimiotherapie antituberculeuse pendant 11 mois complete eventuellement par une stabilisation orthopedique ou chirurgicale de la charniere cervico-occipitale
