[Lupus chorea revealing. Study in magnetic resonance imaging. Success of plasma exchanges after resistance to pulsed cortisone]. / Chorée lupique révélatrice. Etude en imagerie par résonance magnétique. Succès des échanges plasmatiques après résistance aux assauts cortisoniques.

Chorea as a manifestation of SLE is infrequent (1% of all cases of SLE). A new case is reported herein. The patient, a seventeen-year-old female, was admitted with a one-week history of choreic movements of the left half of the body and arthritis of both wrists. Biologic findings confirmed the diagnosis of SLE with presence of an antiprothrombinase circulating anticoagulant. Findings upon cerebral CT scan and magnetic resonance imaging were normal. Clinical symptoms worsened despite corticosteroids in a daily dosage of 1 mg/kg with three pulses of 800 mg methylprednisolone. High-dose neuroleptic therapy was given and three plasma exchanges were performed. A dramatic improvement in clinical symptoms and biological anomalies occurred and persisted during follow-up which now exceeds one year. The lack of MRI anomalies suggests that the pathogenesis of SLE-associated chorea involves functional neurone activation by immune complexes; the dramatic effectiveness of plasma exchanges may obviate the need for using immunosuppressant agents in patients who fail to respond to corticosteroids.

Knee arthritis revealing acute leukemia in a patient with rheumatoid arthritis.

We report one case of leukemic synovitis in a patient with a 40-year history of rheumatoid arthritis. The synovial fluid sample and synovial biopsy specimen showed myeloblastic cells. So, leukemic synovitis can be suspected in a patient with inflammatory rheumatism and adequate diagnostic procedures should be carried out.

[MRI and chronic osteoarticular infections. Contribution of inversion-recuperation sequence with fat signal cancellation in the follow-up of chronic osteitis under medical treatment. Apropos of 14 cases]. / IRM et infections ostéo-articulaires chroniques. Apport de la séquence inversion-récupération avec annulation des graisses dans le suivi des ostéites chroniques sous traitement médical. A propos de 14 cas.

MR Imaging was performed with T1 weighted, Rho T2* (Grass) and S.T.I.R. sequences on medically treated chronic osteomyelitis patients. MR Imaging is definitely the best tool available in thorough evaluation of the extent of lesions. It allows the evolution or remission of focal inflammatory lesions to be traced for follow up. Bone sequestra needing surgery can be identified and soft tissue abcesses differentiated from cellulitis. In future, MR Imaging could replace tomography and fistulography, while scintigraphy would be more useful in cases of recent acute infections and their differential diagnoses.

[Systematic study of various tumoral markers in prevalent bone metastasis]. / Apport de l'étude systématique de différents marqueurs tumoraux dans les métastases osseuses prévalentes.

In the presence of prevalent bone metastases, the precise histo-pathological diagnosis of the primary tumor is often difficult. The authors study the diagnostic value of systematic serum assay of a series of tumoral tracers (ACE, AFP, PAP and PSA, SCC, CA 19:9, CA 15:3, CA 125) which until now were used in evolutive and therapeutic monitoring. 34 patients were selected for this preliminary retrospective study (including 20 with a demonstrated histopathological diagnosis). 70 p. cent of prevalent bone metastases express a target tracer corresponding to the initial location. In some cases, an elevated tracer, because of its specificity, may bring about a diagnostic or therapeutic decision (always according to the context). No conclusion may currently be drawn in case of discordance between the anatomo-clinical context and the "profile" of the markers (1 case in our series).

Social indicators: for individual well-being or social control?

This article is concerned with the way that social statistics reflect particular views of the world, and focuses on the specific case of the Organization for Economic Cooperation and Development's program to develop a set of social indicators. Some illustrations of previous attempts to collect social indicators are given, but the bulk of the article discusses the series of contradictions which regulate the generation and use of statistics by governments, the principal one being between measures which play the ideological role of displaying economic and social "progress" and measures which are of direct use in social planning. This is discussed both for social indicators in general and for social concerns linked to the measurement of health. The article ends with an attempt to evaluate the future of the OECD program within the development of modern capitalism.