Fibromyalgie associée à la gonarthrose: prévalence, caractéristiques épidémiologiques, et son impact sur le traitement / Fibromyalgia associated with knee osteoarthritis: prevalence, epidemiological characteristics, and impact on its treatment

Contexte et objectifs. Les patients souffrant de syndrome fibromyalgique sont fréquemment rencontrés en pratique clinique et déconcertent bien souvent les médecins. Notre étude a pour but de déterminer la prévalence de la fibromyalgie chez les patients gonarthrosiques, son impact sur la présentation clinique et radiologique ainsi sur le cours évolutif de gonarthrose. Méthodes. Il s'agissait d'une étude transversale analytique portant sur les patients atteints de gonarthrose définie selon les critères ACR, suivis au service de rhumatologie de l'hôpital militaire Moulay Ismail à Meknès ; entre novembre 2018 et avril 2019. La fibromyalgie était retenue chez les patients remplissant les critères ACR 2010. Résultats. Au total 101 patients (âge moyen : 57+11,5 ans, femmes : 65,3 % ; surpoids : 35.6% ; et obésité stade 1 (35,6 %) ont été examinés. La prévalence de la fibromyalgie était de 34,7%. Un tiers des patients fibromyalgiques avaient une réponse partielle au traitement (AINS et paracétamol). L'analyse bivariée a montré une association positive avec le sexe féminin (p =0,006) et l'IMC (p=0,017). Par contre on n'a pas noté de relation entre la fibromyalgie, l'âge, le stade radiologique de la gonarthrose, la présence d'un syndrome métabolique, et l'EVA douleur. Conclusion. La fibromyalgie est relativement fréquence chez les patients gonarthrosiques. Sa reconnaissance permet de mieux prendre en charge les patients gonarthrosiques et d'éviter les abus de traitements symptomatiques notamment les AINS.

Context and objective. Fibromyalgia syndrome cases are frequent in clinical practice and often disconcert physicians. The aim of the present study was to determine the prevalence of fibromyalgia in patients with osteoarthritis, and its impact on the clinical and radiological presentation, as well as its evolutionary course. Methods. This was an analytical cross-sectional study including all patients followed for gonarthrosis in the Department of Rheumatology of the Moulay Ismail Military Hospital between November 2018 and April 2019. Fibromyalgia was retained in patients meeting the ACR 2010 criteria. Results. One hundred one patients (57 + 11.5 years old; Women 65.3%; overweight: 35.6%, obesity grade 1: 35.6 %; were examined. The prevalence of fibromyalgia was 34.7%. One third of fibromyalgia patients had a partial response to treatment. The bivariate analysis showed a positive correlation with the female sex (p = 0.006) and the BMI (p = 0.017). There was no correlation between fibromyalgia, age, the radiological class of gonarhtrosis, the presence of metabolic syndrome, and VAS pain. Conclusion. The fibromyalgia is relatively common in patient with gonarthrosis, especially in obese women. Early diagnostic of fibromyalgia offers the possibility of a better management of gonarthrosis patients and thus avoiding the abusive use of symptomatic treatments, notably NSAIDs

Open versus laparoscopic appendicectomy in acute appendicitis: results of a district general hospital

Background:Despite multiple studies comparing the two methods, the real advantages of laparoscopic appendicectomy (LA) compared to open appendicectomy (OA) are still unclear. Purpose of the current study was to compare the results between the two techniques in a district general hospital.Methods:The electronic records of all patients who underwent OA or LA in a one year period were reviewed retrospectively. The comparative data points assessed included age, gender, overall complications, length of stay and Clavien-Dindo Classification of Surgical Complications, including the rates of the main types of complications. Results:300 patients were included in the study. 166 patients underwent OA and 134 patients LA. Postoperative complications were documented in 26 patients (8.7%). LA was employed predominantly in female patients (p = 0.004) and in older patients (p = 0.0015) and was associated with significantly more negative appendicectomies than OA (p = 0.002). No statistically significant difference was noted with regards to the length of hospital stay (p = 0.577), overall postoperative morbidity (p = 0.543) and grading of complications (p = 0.460). Finally, following comparison of the incidence of specific types of complications, only wound infections were significantly different, in favour of LA.Conclusions:LA is safe and effective, however, besides the lower incidence of wound sepsis, demonstrates no clear advantage over OA. The selection between OA and LA should thus be tailored to the clinical scenario and the surgeon's preference

The Effects of Lateral Wedge Insole in the Management of Patients with Varus Osteoarthritis of the Knee

Although insufficient evidence supports the application of lateral wedge insole (LWI) as a non-operative treatment for medial/varus osteoarthritis of the knee joint; objective evaluation of its effects on pain; stiffness and functional disability is limited. The purpose of the study therefore was to determine the effect of LWI on the functional disability and symptoms resulting from the medial/varus osteoarthritis of the knee.Fifty (50) out of 76 patients referred for physiotherapy with diagnosis of varus osteoarthritis of the knee joint participated in this study. The 50 subjects were randomly assigned into 2 groups of 25 patients each. Group A (Experimental); were treated with thermal therapy; massage and LWI. Group B (Control); were treated with thermal therapy and massage only. The outcome measures included knee pain; knee stiffness and functional disability. These parameters were statistically analysed pre and post treatment.Results established a significant difference (p0.05) post treatment between the 2 groups for the outcome measures except knee stiffness. It can be inferred from the results that the therapeutic reduction in pain intensity and enhanced physical activities in group A compared with group B was induced by the LWI.These results provide some insight into the functional effects of the LWI on pain; knee stiffness and functional disability of patients with medial osteoarthritis of the knee. This makes the LWI a useful treatment modality in the management of varus osteoarthritis/varum gonarthrosis

Les osteoarthrites de l'enfant dans le service de chirurgie pediatrique de l'hopital Gabriel Toure : a propos de 41 cas

Au cours de notre periode d'etude de janvier 2001 a janvier 2004; 5046 hospitalisations ont ete effectuees dans le service. La frequence des osteoarthrites est de 0;8; 41 cas. L'age moyen des patients etait de 4;58 ans avec des extremes de 0 a 15 ans et un sexe ratio de 1;73 en faveur du sexe masculin. Le facteur favorisant le plus note a ete la drepanocytose (70;8). La tumefaction (63;4) ; la douleur articulaire (100) sont les signes cliniques les plus frequemment rencontres et la fievre dans (84;4). L'articulation la plus atteinte a ete la hanche (48;8) et le germe le plus retrouve le staphylocoque dore (48;8). La prise en charge a consiste a une mise a plat (drainage chirurgical) associee a une immobilisation du membre atteint et une antibiotherapie adaptee au germe.; 41cas. L'age moyen des patients etait de 4;58 ans avec des extremes de 0 a 15 ans et un sexe ratio de 1;73 en faveur du sexe masculin. Le facteur favorisant le plus note a ete la drepanocytose (70;8). La tumefaction (63;4) ; la douleur articulaire (100) sont les signes cliniques les plus frequemment rencontres et la fievre dans (84;4). L'articulation la plus atteinte a ete la hanche (48;8) et le germe le plus retrouve le Staphylocoque dore (48;8). La prise en charge a consiste a une mise a plat (drainage chirurgical) associee a une immobilisation du membre atteint et une antibiotherapie adaptee au germe

Utilisation de la prothese de Moore dans la chirurgie de la hanche : a propos de 5 cas

"Les auteurs rapportent dans ce travail retrospectif cinq observations d'arthroplastie de hanche par prothese de Moore. La coxarthrose et les sequelles de fractures du col du femur representent les principales indications; l'utilisation de la prothese ""tete de Moore"" garde encore; dans les milieux sous-equipes; une place de choix dans la chirurgie de la hanche; compte tenu du cout du materiel; de la simplicite de la technique et des resultats post-operatoires"

Oruvail in the treatment of Nigerians with osteoarthritis"

"An open; non-comprative study was carried out in 144 patients with osteoarthritis of the knee; spine; hip and shoulder to determine the efficacy and tolerence with ""oruvail""; a controlled-release pellet-formulation of ketoprofen. The results of the subjects and objective assessments before and during 6 weeks treatment showed improvement in all parameters. The trial also showed that oruvail is well tolerated; producing minimal side effects. We conclude that oruvail is a useful addition to the therapeutic armamentarium against osteoarthritis in Nigerians"