[Infection by the hematogenic route of closed vertebral fracture: apropos of a case and review of the literature]. / Infection par voie hématogène d'une fracture vertébrale fermée: A propos d'un cas et revue de la littérature.

We report a new case of haematogenous infection at the site of a spinal fracture. The patient developed a severe bronchopneumonial infection. After the trauma three weeks later he developed a severe but incomplete cord lesion due to acute vertebral osteomyelitis. The patient was treated with antibiotics. He made a slow, but uneventful and complete neurological recovery. 28 instances of osteomyelitis after fracture of which seven involved vertebral bones have been previously reported. The spontaneous appearance of haematogenous osteomyelitis in a fractured bone is a rare but not exceptional event.

Hemidiaphragmatic paralysis, an unusual presentation of Parsonage-Turner syndrome.

A previously healthy 38-year-old man presented a typical Parsonage-Turner syndrome (PTS) three weeks after a cold and unusual muscular exercise. In addition to the motor and sensory defects of the upper limbs, a right hemidiaphragmatic paralysis occurred, which proved to be reversible after several months. A brief review of the hemidiaphragmatic injury in PTS is presented.

Pattern of Lyme arthritis in Europe: report of 14 cases.

Fourteen cases of Lyme arthritis are reported. The most frequent picture was that of oligoarthritis appearing in that part of the leg where the cutaneous or neurological complications, or both, of Lyme disease had developed before the arthritis. In most cases recovery followed a single 10 day course of intravenous (IV) penicillin therapy. Arthritis was the presenting feature of Lyme disease in three cases.

Pustulotic arthroosteitis and chronic recurrent multifocal osteomyelitis in children. Report of three cases.

We describe 3 children with pustulosis palmaris et plantaris associated with chronic recurrent (multifocal) osteomyelitis, located in the clavicle in 2 patients, and in the distal fibula as well as in several metatarsals in the third. The first 2 children also developed inflammatory sacroiliitis, one with chronic peripheral polyarthritis. These 3 cases represent the arthrosteitis and chronic recurrent multifocal osteomyelitis syndrome associated with palmoplantar pustulosis.

Is APD a promising drug in the treatment of severe osteogenesis imperfecta?

The efficacy of (3-amino-1-hydroxypropylidene)-1,1-biphosphonate (APD) is reported in a severe case of osteogenesis imperfecta (OI). An increased density at the metaphysis level is demonstrated on wrist radiograph. Similar findings have been observed in two other children with OI at various metaphyseal levels (e.g., tibia, femur). To our knowledge, this is the first time the effect of APD in children with severe OI has been reported.

[Loss of digital substance in rheumatic diseases. Apropos of 43 cases]. / Pertes de substances digitales dans les maladies rhumatismales. A propos de 43 observations.

The authors briefly summarize 16 cases involving digital necrosis observed in the course of rheumatic disorders (3 carpal tunnel syndromes, 2 cases of panarteritis, 2 of rheumatoid arthritis, 2 of lupus erythematosus, 2 of scleroderma, 2 of dermatomyositis, 1 of adult form of Still's disease, 1 of gout, and 1 case of cryoglobulinemia). In addition the case reports of 129 patients with connective tissue disease were reviewed (74 cases of disseminated lupus erythematosus, 43 of scleroderma, and 12 mixed connective tissue disorders). Soft tissue destruction of digits was observed in 15, 39 and 25% of these patients respectively, and true tissue necrosis of varying extent in 7, 9 and 0% of these cases. The incidence and pathogenic mechanisms responsible for these disorders and lesions were discussed.

Hypertrophic osteoarthropathy related to end stage cholestatic cirrhosis: reversal after liver transplantation.

A case is reported of hypertrophic osteoarthropathy with recovery after a liver graft in a young man with end stage cholestatic cirrhosis related to non-Wilsonian copper overload. To our knowledge this is the first case in the literature illustrating the curative role of liver grafting on hypertrophic osteoarthropathy associated with chronic cholestatic liver disease.

Pustulotic arthro-osteitis in children and adults. A report of 13 cases.

Thirteen cases of pustulotic arthro-osteitis are reported: 3 children and 10 adults. The clinical and radiological aspects of this rare entity are discussed as well as the classification of this disease in the context of seronegative spondyloarthropathies.

New modes of administration of salmon calcitonin in Paget's disease. Nasal spray and suppository.

In volunteers the activity of various doses of a nasal spray and of a suppository of salmon calcitonin was compared to a placebo and to the parenteral route of administration. Both new modes of administration were found to be active on the kidney (and the suppository was found to affect bone turnover as well). The parenteral route proved more effective, but the nasal and/or rectal routes were devoid of systemic side effects and had minimal local intolerance. The nasal spray was used at 200 units daily in 15 patients with Paget's disease, and at 400 units daily in another nine patients, both trials lasting one year. The two regimens proved active on the parameters of bone turnover and the higher dose was more effective than the lower one. Similarly, a 300 unit suppository was given to another 12 patients. This trial is still being completed at this time. At the third month of therapy, the parameters of bone turnover were significantly depressed. Both new modes of therapy were able to improve the focal bone balance of the osteolytic lesions monitored on sequential roentgenograms. Systemic side effects were absent and local side effects were minimal. Only one patient interrupted the nasal spray therapy, and no one interrupted the suppository therapy.

Klinefelter's syndrome and lupus erythematosus: report of a case.

We report a case of SLE related polyarthritis in a 28 year-old man with Klinefelter's syndrome treated with testosterone for 13 years. Clinical outcome was favorable with low doses of corticosteroids. The pathogenesis of that strange association is discussed.

Haemophilus aphrophilus: a rare pathogen in vertebral osteomyelitis.

A case of vertebral osteomyelitis due to Haemophilus aphrophilus is presented. We review the clinical and bacteriological findings and emphasise the need for careful bacteriological investigation. To the best of our knowledge this is the second reported case of vertebral osteomyelitis caused by this rarely recognised pathogen.