[Study of bone mineral density in adolescent handball players: about a study of 20 cases]

The physical activity during adolescence seems to correlate with bone mass at the end of the growth period. To determine the effect of handball regularly practiced by teenage girls on the anthropometric parameters and bone mineral density. Cross-sectional case-control, made in the rheumatology department of the Rabta hospital, has enrolled adolescent handball players of high level, which were compared to a control group matched by age and sex, but sedentary. We evaluated our two groups for anthropometric parameters and BMD. The lean mass [LM], fat mass [FM], the mean values of BMD at the lumbar spine and femur of our sports were significantly higher than that of sedentary controls. On bone mineral content [BMC], a statistically significant difference was observed between groups of sedentary and athletic teenagers. Positive and significant correlations were found between anthropometric parameters and measurements of BMD, BMC and of bone area. The regular practice of handball seems to be an osteogenic factor. It may be advisable in adolescents during the growth period to optimize the bone

[Usefulness of magnetic resonance imaging in the diagnosis of early rheumatoid arthritis: a prospective study about 20 cases]

Diagnosing early rheumatoid arthritis is difficult and radiographic signs are often late. MRI detects erosions at an early stage and visualizes synovitis, bone edema and tenosynovitis. To assess the value of MRI for diagnosis of early forms of rheumatoid arthritis. Prospective study involving 20 patients who had non erosive rheumatoid arthritis lasting for less than 2 years. MRI of the hand was performed by sequences coronal and axial T1-weighted, T2 with saturated fat signal [FatSat] FatSat and T1 with gadolinium injection. The median age of patients was 52 years and sex ratio M/F of 0.05. The median disease duration was 9 months. Ten patients had antibodies Anti-Cyclic citrullinated protein positive. The MRI was abnormal in 75% of patients. This review found 36 erosions which 50% were in carpal bones, 55 joints with synovitis mainly localized midcarpal and metacarpophalangeal. Bone edema was found mainly in carpal bones. Tenosynovitis affected most frequently the flexor tendons. Seventy percent of patients without anti-Cyclic citrullinated protein had a pathological MRI. MRI has an important role in detecting infraradiological lesions in early RA. This contributes to early diagnosis and initiation effective treatment

[Pathophysiology of complex regional pain syndrome [CRPS] type 1]

If the pathophysiology of complex regional pain syndrome [CRPS] type 1 remains controversial, most authors agree on a combination in varying proportions, a sensitization of peripheral nerves. To describe the state of advances in the physiopathology of complex regional pain syndrome type 1. Bibliographic research and literature review performed by referring to databases [Medline, Science Direct]. The physiopathology of complex regional pain syndrometype 1 remains still poorly understood and controversial. Several arguments demonstrated both peripheral [inflammation, abnormal sympathetic ...] and central [neurological and cognitive] mechanisms. A better knowledge of the physiopathology of complex pain syndrome type 1 is necessary in order to adapt efficient curative therapy or to a better prevention of this syndrome

[Rheumatic manifestations of genetic hemochromatosis]

Rheumatic manifestations of genetic hemochromatosis are frequent with axial or peripheral arthropathies [mono-, oligo- or polyarticular]. These manifestations are characterized by articular damage and osteoporosis. To review the rheumatic manifestations of genetic hemochromatosis. A narrative review of literature. The diagnosis should be brought to mind when we discover arthropathy resembling degenerative joint disease with involvement of unusual articular sites, almost identical to the arthropathy in calcium pyrophosphate dihydrate crystals deposition disease [chondrocalcinosis]. There is a significant bone loss in HC that cannot solely be explained by hypogonadism or cirrhosis and must lead to measure bone mass density to each patient with HC

Rheumatoid arthritis: current status of therapy

Rheumatoid Arthritis [RA] is a frequent chronic inflammatory disease characterized by distal, bilateral and symmetrical lesions, leading to joint distortions and articular destructions. RA can also cause severe extra-articular manifestations associated with a poor prognosis. Recent advances in the field of immunopathology of RA have oriented treatment targeting the pro-inflammatory cytokines like tumor necrosis factor-a [TNF alpha], interleukin [IL]1 and IL6. These biotherapies are considered as an important therapeutic progress in the treatment of RA acting at the level of cellular processes responsible for rheumatoid disease. These new therapies are active not only in controlling the disease inflammatory processes but also to stop the radiological course of RA. These new therapies are however efficient as long as prescribed, their interruption being rapidly followed by a flare-up of RA. Multiple adverse events attributed to anti-TNF-alpha have been described especially severe opportunistic infections and tuberculosis. B cells playing a critical role in sustaining the chronic inflammatory process in RA, targeted depleting B cells therapies have been developed in refractory forms of RA giving promising results. However, before any biotherapy prescription especially of anti-TNF-alpha, an initial screening should be achieved to exclude patients with history of untreated tuberculosis, solid cancers, malignant hemopathies or demyelinating disorders. It is also essential to assure a strict follow-up in patients under biotherapy to detect adverse events that can be sometimes severe. Thus, the ratio benefit/risk must be evaluated before any biotherapy prescription

[Juvenile idiopathic arthritis and lyme disease: a case report]

Lyme disease is a systemic infection due to Borrelia burgdor-feri. Joint involvement in children, when primary phase is unknown, can be confounded with juvenile idiopathic arthri-tis. We report a case of a 16 years old girt. who developed at the age of 14 a bilateral and symetrical polyarthritis of big and small joints with fever and cutaneous eruption of trunk. No clinical improvement was seen under disease modified treatment. More biological investigations were performed. leading to the diagnosis of Lyme disease. Clinical recovery was obtained under adapted antibiotherapy, Hence Lyme serology must be performed when atypical polyarthritis appears in a child especially in an endemic region of borrelia. burdogferi