[Benign osteoporotic vertebral fracture due to compression of the spinal cord?]

A neurologic compromise associated with vertebral fractures is generally due to a malignancy causes. Therefore, an osteoporotic vertebral fracture can sometimes cause neurologic complications. Report a case of neurologic compromise associated with osteoporotic vertebral fractures. A-62-year-old man suffered from rheumatoid arthritis since 1985, presented a cervical pain associated with quadriparesia secondary to a C5 osteoporotic vertebral fractures. Osteonecrosis may be the cause of neurologic compromise associated with osteoporotic vertebral fractures

[Primary spinal epidural abscess - a case report]

Spinal epidural abscess is a rare affection in child. Bacteria gain access to the epidural space through contiguous spread or hematogenous dissemination. It is more common in thoracolumbar than cervical areas. The organisms most frequently encountered are Staphylococcus aureus. Back pain, fever and neurologic deficit are the three most common symptoms. MRI is the imaging method of choice in diagnosing spinal epidural abscess. Surgical drainage with systemic antibiotics is the treatment of choice. We report the case of a 8 years old children, without any pathological antecedent, hospitalized in the service of Pediatrics for back pain, fever and lameness. The clinical examination found a lumbar rachis painful to the palpation with limited mobility, there was no neurologic deficit. Laboratory investigations showed that inflammatory markers were uniformly elevated. MRI showed a spinal epidural abscess in L3-L4. No micro-organism was isolated in blood cultures. A diagnosis of spinal epidural abscess was suspected and a medical treatment was indicated for 3 months. The outcome was favorable. On the light of this observation, the authors make a review of literature

Imaging in the screening and diagnosis of hepatocellular carcinoma in cirrhosis liver in tunisia. a series of 30 cases

The aim of our study is to expose a practical screening and diagnosis strategy of HCC occuring in cirrhosis liver, which is nowadays a health public matter in Tunisia. HCC routine screening in cirrhosis liver has been conducted every 6 months using a combination of abdominal sonography and serum alpha-foetoprotein levels. PCUS, CT scan or MRI have been performed each time a focal liver lesion was discovered in US, or in case of elevated serum alpha-foetoprotein levels. 30 cases of HCC were identified.US has shown a unique nodule in 46% of the cases, multiple nodules in 50% of them. No lesion has been discovered in 4% of the cases. Nodule size ranged from 8 to 140 mm. Heterogenous hyperechoic pattern was the most frequent one [41%]. Hypervascular doppler feature was authentified in 20% of the cases. Serum alpha-foetoprotein levels had respectively a sensitivity and a specificity of 14% and 44% in lesions inferior to 3 cm, 62% and 80% in lesions superior to 3 cm. Typical arterial enhancement of HCC was depicted in 1 case for PCUS, in 76% for CT scan and 60% for MRI. Combination of abdominal sonography and serum alpha-foetoprotein levels practiced every 6 months represent a good compromise between cost and effectiveness. Second intention imaging is based on CT scan in Tunisia because of its availability compared to MRI. PCUS is becoming in the near future the best modality for lesion caracterization thanks to its safety and relative inexpen