312 Works

Management of severe rheumatoid arthritis : therapeutic options for Moroccan patients without health care

Mirieme Ghazi
Thepastdecadehasbroughtimportantadvances in the understanding of rheumatoid arthritis and its management and treatment. New national and international evidence-based recommendations for management of rheumatoid arthritis, better definitions of treatment outcome and remission, and the introduction of biologic response-modifying drugs have greatly altered the approach to managing this disease. Unfortunately, the cost of treating rheumatoid arthritis has also risen dramatically, largely as a consequence of the biologic therapies. Health care concerns 60% of Moroccan population, shared between compulsory...

MRI in diagnosis of spondyloarthritis

Yassine Lemrhari
Objective: The aim of this study is to compare the sensitivity of MRI, clinical examination and standard x-ray of sacroiliac joints and lumbar spine in spondyloarthrites. Methods: In a retrospective study, patients with spondyloarthritis were included according to AMOR criteria, in the 2003-2015 period. All patients had standards x-rays and MRI examination of the sacroiliac joints and/or the lumbar spine. The radiographs and MR scans were evaluated by a senior rheumatogist, according to MRI LEEDS...

Rheumatic manifestations of human deficiency virus

Nora Righi
Since July 1983, many rheumatic manifestations, including musculoskeletal and immunological disorders have been described in patients diagnosed with HIV and AIDS. Jointinfections may happen but are less frequent than expected, and affect patients with important cell immune deficits. Reactive arthritis, psoriatic arthritis, non-specific acute arthritis, Sjögren syndrome and inflammatory myositis have been reported. A recent literature review has reinforced the perception that association between HIV/AIDS and autoimmune diseases is mainly represented by reactive arthritis. The...

Ultrasonography patterns of gout

Karima Benbouazza
The role of musculoskeletal ultrasound has increased rapidly in the diagnosis of deposits of sodium urate crystals in the last ten years. Ultrasound can provide valuable support for making quick decisions in various situations of everyday practice: diagnostic orientation, diagnosis and topographic mapping of urate deposits, adjustment and possibly therapeutic monitoring of disease. This review illustrated by clinical case reports focuses on the contribution of ultrasonography in gout.

Diagnostic and treatment of osteoporotic vertebral fracture

Imane El Bouchti
The osteoporotic vertebral fracture is an acquired reduction in localized or diffuse height of the vertebral body outside any violent trauma. Most of osteoporotic vertebral fractures are asymptomatic. These fractures have a considerable socio-economic impact and their management is a problem of public health wich implies the rheumatologist in the foreground. It represents the dominant etiology of non traumatic-vertebral fractures. However, it remains a diagnostic of elimination. It is necessary to conduct a rigorous diagnostic...

Eosinophilic fasciitis or Shulman syndrome : report of a case and literature review

Charaf Eddine Elkassimi
Eosinophilic fasciitis is a rare disease, described by Shulman in 1974. It combines edema members to eosinophilia. Edema gradually gives way to a subcutaneous induration, reaching forearms and legs. The hands and face are usually spared. There are no Raynaud’s phenomena or autoimmunity marker. Diagnosis is suggested by the clinic Clinica, enhanced by Magnetic resonance imaging (MRI) and confirmed by histology. The MRI shows a thickening of the superficial and deep fascia, best seen after...

The immunological markers of rheumatoid arthritis

Jalila El Bakkouri
Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disease. It is characterized by symmetric inflammation of synovial membranes of the joints that can cause their destruction. Starting treatment at an early stage of RA can limit the radiological outcome of patients. A good serological marker is necessary either at the beginning of the disease and during follow-up. Indeed, serological markers may help clinicians predict prognosis and indicate a more aggressive treatment. We propose, through this...

Association between clinical risk factors, fall’s history, osteoporosis or fractures among patients referred to an open access bone densitometry service

Kawtar Nassar
Introduction: The reduction in bone density assessed by dual-energy X ray absorptiometry and fall history represent the first two risk factors of non-vertebral fracture. Several publications indicate osteodensitometry to subjects with experienced falls in search of bone fragility and may justify a treatment for osteoporosis. Study purpose: Determine the prevalence of risk factors justifying bone densitometry, those of falls, osteoporosis and fractures. Because of the reduce attention according to falls, the mean purposes were the...

Multiple embolisms in endocarditis : what if it is not infective ?

Ali Chaib
The infectious origin is the most common etiology of endocarditis. However, other causes should be raised when the evolution under antibiotic treatment is atypical. We report the case of a young pregnant patient, admitted for suspected infective endocarditis with fever and mitral vegetation. The negative blood cultures, unfavorable evolution, the occurrence of thromboembolic events and the results of multiple immunological investigations led to the diagnosis of Libman-Sacks endocarditis in the context of catastrophic antiphospholipid syndrome....

Exophthalmitis revealing Paget’s disease of the sphenoid bone in a Comorian

M. Véronique Ranaivoarison
Paget’s disease or Osteitis deformans are a benign osteodystrophia which is generally asymptomatic. Rare case of its disease is reported from African people. We are exposing one case of a Comorian woman of 56 years old who presented an isolated exophthalmia, and which was finally a Paget’s disease symptomatology of sphenoidal bone. Characteristic Cerebral tomodensitometry aspects and benignity of evolution argued highly diagnosis. Particularity of our case reporting is both on the atypical side primitively...

Relapsing polychondritis : an update

Taoufik Harzy
Relapsing polychondritis (RP) is a rare disorder characterized by recurrent inflammatory episodes involving the cartilage of the ear, nose, larynx and the tracheobronchial tree. Other initial manifestations are various and less evocative: polyarthritis, laryngo-tracheal symptoms, episcleritis which can delay the diagnosis. Nowadays, it is considered to be an autoimmune disease. The diagnosis is clinical. It can be based on the criteria of Michet [1]. Treatment of the disease is not codified. It i depends on...

Risk factors of osteoarthritis of the knee among rheumatology patients in Lomé (Togo)

Oniankitan Owonayo
Introduction : Risk factors of osteoarthritis of the knee have not been sufficiently studied in the Sub-Saharan Africa. Aim of the work : To determine the frequency of the risk factor of osteoarthritis of knee in patients admitted to the Rheumatology Department in Lomé (Togo). Patients and Methods : A retrospective study was conducted over 17 years on records of hospital patients admitted for Osteoarthritis of the knee Medical records of patients admitted to the...

Study of bone mineral density and fracture risk in adults with type I diabetes

Raoudha Tekaya
Introduction : The impact of type I diabetes on bone mass and fracture risk remains a matter of debate. The aim of this study is to study bone mineral density and fracture risk in adults with type 1 diabetes. Methods : This is a case control study including 40 type 1 diabetes patients and 40 controls matched by age and sex. Persons who had secondary osteoporosis were excluded. Bone mineral density was measured at the...

The respiratory complications of biological therapy

Rachid Bouchentouf
Actually the use of biological therapy has changed the management of several inflammatory diseases. They have been used for treating rheumatoid arthritis. However, the use of these drugs has revealed during the formal years many side effects dominated by infectious complications who are causes important of morbidity and mortality. The physicians should always be aware in the use of targeted therapy according to guidelines. It’s recommended to realize a complete pretherapeutic assessment and it is...

The care management of a polyalgic syndrome

Zainab Elhadrami
Polyalgia refers to diffuse musculoskeletal pain which differ from «regional» pain by a greater extension, affecting at least three non-contiguous regions of the limbs or trunk. They are a main reason for consultation in rheumatology. The aim of this article is to recognize the diagnostic approach to diffuse pain and list their different etiologies.

Primary hyperparathyroidism : who should have surgey ?

Jihad Moulay Berkchi
Primary hyperparathyroidism (HPTHp), a widespread endocrinopathy that affects mostly women between 50-70 years. It includes several diseases whose common point is an initial parathyroid lesion which leads to an increase in production and secretion of parathyroid hormone (PTH), itself responsible for deregulation of phosphocalcic metabolism and its consequences on bone tissue, which the most characteristic result is hypercalcemia. The diagnosis of HPTp is a biological diagnosis, since the asymptomatic forms are the most frequent which...

Diaphyseal femur fracture in pycnodysostosis : a case report

Ahmed Reda Haddoun
A rare case of a 14 year old patient with pycnodysostosis having shaft femoral fracture is being reported. He had typical facial features, short stature, open fontenella, short stubby hands and radiological features including open cranial sutures, obtuse angle of mandible, dysplasia of lower end of radius and ulna. The fracture was treated with a dymanique plate . The fracture united in 12 weeks. We discuss the clinical and therapeutic aspects specific to the pycnodysostosis...

Hyaluronic acid : structure, synthesis and biological effects

Akasbi Nessrine
The hyaluronic acid is a glycosaminoglycan which is synthesized in the plasma membrane of many cells. Its metabolism is regulated by hyaluronan synthases and hyaluronidases. It is an essential component of synovial fluid responsible for its lubricity and its damping properties. In addition to its structural role, hyaluronic acid regulates the immune response, angiogenesis, inflammation and the tissue healing. There are two methods for obtaining hyaluronic acids used in therapeutic: bacterial fermentation and extraction from...

Algodystrophy : what therapeutic management ?

Nadira Kadi
Complex Regional Pain Syndrome type I (CRPS-I) is a condition that causes multiple problems for both patients and practitioners, especially in terms of treatment options which are subject to discussion. The purpose of this paper is to review the different therapeutic modalities applicable to support this affection.

Rheumatologic manifestations of the hand and shoulder in diabetic

Sanae El Hadri
Musculoskeletal manifestations of diabetes mellitus, whether type 1 or type 2, are common and diverse, all directly or indirectly related to chronic hyperglycemia. Their prevalence is generally correlated with poor glycemic control and the occurrence of other complications of diabetes. In diabetic patients, some of these osteoarticular complications primarily affect the hand and shoulder. We distinguishe the limited joint mobility that include the cheiroarthropathy, the trigger finger, Dupuytren's disease and the shoulder capsulitis. Associated with...

Late bilateral osteoradionecrosis of the hip

Moez Ouertatani
Tuberculosis is a rare cause of hypercalcemia; whose main etiologies remain dominated by malignancies; or hyperparathyroidism. We report a particular observation for atypical revelation of Multi visceral tuberculosis. A 72-year-old patient is admitted for etiologic diagnosis of spinal pain, health impairment with inflammatory syndrome and major hypercalcemia 139mg / l rechecked. After rejecting a neoplastic pathology, suspected first due to the age and to general signs, the different clinical and para-clinical investigations have raised the...

Epidemiology of hip fractures between 2006-2009 in the region of Rabat

Asmaa Rezqi
Introduction : No data on hip fracture incidence trends exists from Africa. The aim of the study was to determine time trends in hip fracture rates for the province of Rabat and to forecast the number of hip fractures expected in Morocco up to 2050. Methods : All hip fracture cases registered during the years 2006–2009 were collected at all the public hospitals and private clinics with a trauma unit and/or a permanent orthopedic surgeon...

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