Magnetic resonance imaging of the wrist in rheumatoid arthritis: comparison with other inflammatory joint diseases and control subjects.

The aim of this study was to evaluate magnetic resonance images (MRI) of the wrist of rheumatoid arthritis (RA) patients. MRI and plain X-ray of the wrists were performed in 15 patients with RA, 7 patients with another chronic inflammatory joint disease (CIJD), and 10 control subjects. Patients had only minor changes on plain X-ray. Coronal T1 weighted spin echo sequences were performed before and after an intravenous pulse of gadolinium (GD). Contiguous 3 mm thick slices were obtained. Synovitis was frequently objectivized in the two groups of patients. MRI detected far more erosions and central bone geodes than plain X-ray. Geodes were frequent among controls while cortical bone erosions were frequent in patients. Most of the erosions were enhanced after GD injection in the RA patients but not in the 2 other groups. Thus MRI is not only useful in diagnosing inflammatory changes of the wrist but also in distinguishing early stage RA from other CIJD.

Broadband ultrasound attenuation of the os calcis: preliminary study.

Broadband ultrasound attenuation (BUA) measurements of the calcaneus were performed in 87 healthy subjects and in 17 patients with osteoporotic vertebral fractures. In 52 normal subjects, bone mineral densities (BMD) of the lumbar spine were measured by quantitative CT (QCT), and in another group of 15 normal subjects, BMD of the lumbar spine was measured using dual energy X-ray absorptiometry (DXA). BUA showed a negative significant correlation with age (r = 0.44; p < 0.001), and was more pronounced in women. A significant positive correlation of BUA in the os calcis with lumbar BMD using QCT (r = 0.53, p < 0.001) or DXA (r = 0.81; p < 0.001), was observed. We found no significant difference between osteoporotic patients (n = 17; mean BUA value: 58.4 +/- 18) and controls (n = 17; mean BUA value; 61 +/- 15). The mean coefficient of variation was high: 6%. These results suggest that BUA is not yet a valuable tool in general clinical practice and that further additional improvements are necessary in order to use it in the management of osteoporosis.

[Abdominal neuropathy of motor expression of diabetic origin. Apropos of a case]. / Neuropathie abdominale à expression motrice d'origine diabétique. A propos d'un cas.

Authors report a case of diabetic truncal neuropathy presenting as a painful abdominal swelling. This entity, which frequently is probably under estimated, may mimic abdominal visceral pathology and patients may be subjected unnecessary to extensive diagnosis procedures.

Three cases of arthritis after BCG therapy for bladder cancer.

The authors report three cases of arthritis occurring after treatment with BCG immunotherapy for bladder disease. This complication is observed in 0.5 to 1% of treated patients and affects the small joints within 1 to 5 months of the first BCG injection. The clinical outcome is favourable with non-steroidal antiinflammatory drugs. This form of arthritis may be attributable to a cross-reaction between antigenic components of cartilaginous proteoglycan and BCG, influenced by a particular HLA-DR pattern, and with the intervention of a heat shock protein.

[Evaluation of vertebral bone mass in anorexia nervosa]. / Evaluation de la masse osseuse vertébrale dans l'anorexie mentale.

Lumbar bone mineral content (BMC) of 33 female patients aged 14-30 years (19 +/- 4.1 (mean +/- SD) with anorexia nervosa (duration 31 +/- 37 months) was studied using dual X-ray absorptiometry. Results were compared with the data obtained in a population of 26 women aged 17-38 years without bone disease. BMC was significantly decreased (0.872 +/- 0.107 g/cm2 hydroxyapatite) in anorectic patients as compared to controls (1.008 +/- 0.098 hydroxyapatite). A single patient had a non traumatic vertebral compression fracture. A statistically significant negative correlation was found between BMC and duration of amenorrhea (r = 0.48; p < 0.01). There was no significant correlation between BMC and body mass index or daily calorie intake. Ovarian steroid deficiency might thus be a major factor--among other ones--in the development and the degree of bone loss in anorexia nervosa.

Lumbar bone mineral density in anorexia nervosa.

We studied lumbar bone mineral densities (BMD) using a dual photon absorptiometer in 18 women with anorexia nervosa (AN). Results were compared with data from a control group of 36 healthy women. We found significantly reduced mean bone densities as compared with control group (0.814 +/- 0.072 g/cm2 hydroxy-apatite equivalent vs 1.011 +/- 0.023; p < 0.01). Only one patient developed vertebral compression fracture. BMD was negatively correlated with duration of amenorrhoea (r = -0.68; p < 0.01) but not significantly with duration of AN. We found no correlation between BMD and estradiol blood levels, age of onset, body mass index and daily calorie intake. The correlation between BMD and duration of amenorrhoea may indicate that long standing estrogen deficiency is a major factor in the osteoporosis (OP) observed in AN.

[Chronic hepatitis C and Gougerot-Sjogren syndrome. Apropos of a case]. / Hépatite chronique C et syndrome de Gougerot-Sjögren. A propos d'un cas.

The authors report a patient with concomitant Sjögren's syndrome and chronic hepatitis C. Close associations between autoimmune liver disease, chronic hepatitis C, and Sjögren's syndrome have been demonstrated. The most likely hypothesis involves triggering of an autoimmune cascade by the hepatitis C virus. Prevalence of hepatitis C virus infection in patients with Sjögren's syndrome and potential therapeutic implications of this disease combinations remain to be determined.