[Focus on rehabilitation of shoulder instability treated by Latarjet procedure]

The anterior shoulder instability is a frequent motif of consultation especially in athletic young shoulder. The surgery is indicated when recurrent shoulder dislocations appears or negative physical therapy. The latarjet procedure is the most common surgical technique over the world and in Morocco. The rehabilitation after latarjet procedure has tree objectives: indolence, mobility and a harmonious equilibrium between external and internal rotator muscles. The proprioceptive rehabilitation had to learn to answer quickly and efficacy to every situation cause of instability or shoulder dislocation

[Neglected spontaneous rupture of the patellar tendon [Report of one case]]

A patient taking corticosteroids for asthma experienced a spontaneous neglected rupture of the patellar tendon. The rupture was repaired surgically by tendoinoplasty using the vaster medial and loosened wire cerclage. Even with the rehabilitation knee began immediately after surgery, the results was judged unsatisfied because of the difficulties of total extension. We underline the difficulties of treatment of neglected rupture of the patellar tendon and the bad functional results after surgery and rehabilitation

[Report of a case of hip arthropathy]

The tabetic arthopathies [AT] belong to the neuropathic arthropathies, and are currently rare. The localization in the hip occupies the third place after that of the knee and the foot. We present a case. It is about a 52 years old patient, hospitalized for a painless left chronic coxopathy, revealed by a heaviness, boitery and shortening of the left lower limb. The clinical examination had noted a conservation of the amplitudes of the left hip with luxation of the left femoral head which is preceived in the external iliaque pit as well as an abolition of the osteotendineux reflexes of the lower limbs and a positive sign of Argyll Robertson. Standard radiographies had shown a destruction of the left femoral head and cotyle with posterior luxation of the higher end of the femur. Syphilitic serology was positive in blood and the cephalospinal liquid. Through this observation and a review of the literature, we remind the various clinico-radiological aspects and the therapeutic difficulties of the tabetic arthropathies in particular the localization to the hip. While insisting on the interest of the prevention and the early treatment of syphilis avoiding the late installation of articular and neurological complications

[ adhesive capsulitis about 77 cases]

The adhesive capsulitis of the shoulder is characterised mainly by a passive amplitude loss in the three articular sectors in abduction, antepulsion and external rotation.They raises various etiologies and constitute a major indication to the rehabilitation. The goal of the rehabilitation is to shorten the delay of evolution and to avoid recidivisms. We bring back results of the experience of the unit of rehabilitation of the service of rheumatology of the C.H.U. Ibn Rochd, of 1997 to 2003. It is about 70 patient whose middle age is of 48 years. The picture clinic included a global pain of the shoulder, with to the exam clinic a passive limitation of the articular mobility of at least 40% of the deficit in the abduction, the antepulsion and the external rotation. The balance didn't recover any etiology at 41 patient [60%]. The treatment included a treatment anodyne and anti-inflammatory non sterdidien partner to an infiltration intraarticular of corticosteroids and rehabilitation. A recuperation to 140 degree of the articular amplitudes has been observed in 79% of cases. The adhesive capsulitis is the most often primitive, however an investigation meticulous etiologic imposes itself before keeping this diagnosis. The reach is more frequent at the woman. The rehabilitation permits to get 80% of good results with a total articular amplitude recuperation and an improvement of the functional prognostication

[ Arthropathies tabetics knee [a case about 8]]

Authors report 8 cases of Charcot's joints arthropathies collected between 1993 and 2002, in the Rheumatology Department Ibn litochd hospital of Casablanca. It was about 6 men and 2 women whose middle age is of 55 years. The positve diagnosis is made on the association of the 4 following elements:The major articular deformity contrasting with indolence.The neurological affection of Charcot's joints disease.The radiological signs of destructive arthropathy.The syphilitic reaction positivity in blood, the LCR and the articular liquid. the treatment made call to the G penicillin, the discharge and the wearing of articulated kneepads. We insist on the prevention and treatment of the primary syphilis in order to avoid the intervening its articular and neurological complications

[Echinococcosis from Iliac bone [about one case]]

The bony localizations of hydatic desease are less frequent. We have one observation of hydatidosis of the hipbone in a patient of 44 years old, who presented a chronic right coxopathy, in a context of fever, nocturnal sweats and weakening. The VS was accelerated to 50 mm. The NFS was normal and hydatic serology was negative. Standard x-ray showed a moth-eaten aspect of the -fight ilium, calcifications of the adjacent soft part as well as a global-pinch of the right coxofemoral spacing with osteophytesesosteophyteses. the pelvic TDM found out a lyse extension of the right iliac wing to the cotyle, bony sequesters, endo and exopelvic liquid collections. Echoguided puncture had extracted the pus, the bac-teriological exam [germs + BK banals] of which was negative. It is the surgical exploration with histologic study that allowed to put the diagnosis of bony echinococcosis. The bony hydatidosis puts .1 diagnostic problem but especially therapeutic: the effectiveness of the medical treatment is controversial and the anatomical conditions of the pelvis don't help the radical surgery and expose to the risk of recidivism

[Paget disease of bone [about 7 cases]]

Paget's disease of bone in characterized by increased bone turnover. We report in this retrospective study 7 cases of Paget's disease of bone collected in the department of rheumatology, UHC Ibn Rochd in Casablanca. The study interested 4 males and 3 females. Their mean age was 67 years. Bone pain existed in every case. Radiographic exam revealed a total of 15 localizations. PAS and urinary hydroxyproline were elevated in every case. 3 patients had underwent a scintigraphy of bone. The treatment at first was etidronate in 4 cases and calcitonin in 3 cases

La pseudo-polyarthrite rhizomelique: ses rapports avec la maladie de horton; a propos de huit observations colligees a l'hopital El Ayachi en 7 ans [1980-1986]

The rhizomelic pseudo-polyarthritis or the corsets inflammatory rheumatism which was reported and described under many appellations is an affection that occurs in the elderly and remains ambiguous as for its clinical and etiopathogenic aspects The authors report here eight rhizomelic pseudopolyrthritis cases collected on seven years-period in a rheumatic service. Through a literature review about this affection and its relationship with the Horton's disease, they wonder whether it is question of two different affections or the same disease

L'association lupus erythemateux dissemine-myasthenie: a propos d'un cas, avec revue de la litterature

The myasthenia often is distinguished by the coexistence of other affections which too have an immunologic origin wether proved or probable. The authors report here a myasthenia case found in a patient with lupus disease. Through a literature review about such coexistence, they discuss the relationship between the myasthenia and the lupus. They base their argument as well on statistical, immunologic and genetic data as on the part the thymus plays in the two dideases