[Cervical spondylodiscitis in hospital environment in Lomé [Togo]]

The spine is a frequent site of infection but cervical spine localization seems to be rare. To determine the frequency and features of cervical spondylodiscitis in patients attending the Sylvanus Olympio University Hospital Center in Togo. A retrospective study of patients hospitalized in the Department of Rheumatology over a 20-year period was conducted. The positive diagnosis of infectious spondylodiscitis has been clinical and radiological. The etiological presumption was founded on clinical and epidemiological arguments. Of the 2881 patients hospitalized, 356 had infectious spondylodiscitis of which 15 cases of cervical spondylodiscitis [eight men and seven women]. The average age of these 15 patients was 37 years at the onset of the disease of which the mean disease duration was six months. The disease was essentially located at the levels of C3C4 [seven patients] and C5C6 [four patients]. Spondylodiscitis was related to presumptive tuberculosis in 10 patients and banal germ in the remaining five others. There were three HIV infected patients. The onset of the symptomatology was progressive in all the 10 patients suffering from tuberculosis spondylodiscitis. The symptomatology has been characterized by inflammatory pains [10 patients], mechanic pains [five patients], and a gibbosity [four patients]. This study attests of the scarcity of the cervical spondylodiscitis

Rheumatic diseases profile of 13517 west african patients

To determine the patterns of rheumatic diseases in patients attending the rheumatology unit of the Lom‚ Tokoin teaching hospital. Medical records of patients seen over 16 years period were studied transversally. All the patients suffering of rheumatic disease were including in the study. 13517 patients [7755 women, 5762 men] had suffered of rheumatic disease. Degenerative spinal involvement, n= 6319 [46.47%]; tendinitis, n= 1625 [12.02 %]; knee osteoarthritis, n= 1084 [8.02 %]; chronic inflammatory rheumatism and connective tissue disorders, n= 626 [4.64 %]; infectious pathology, n= 376 [2.78 %] and hip involvement, n= 322 [2.39 %] were the diseases more observed. The features of degenerative spinal disease included low back pain [n= 2325], lumbar and radicular pain suggestive of disc herniation [n= 2035] and lumbar spinal stenosis [n= 709]. More women [n= 874] than men [n= 210] had suffered of knee osteoarthritis. Spondylarthropathies [n=93], rheumatoid arthritis [n= 62], dermatomyositis and polymyositis [n= 13] were the main forms of chronic inflammatory rheumatism and connective tissue disorders. The infection was localized in spine for 191 patients and in other bone and joints for the 185 others. The cause of infection was likely Koch bacillus for 178 patients and trivial germs for the 198 others. Necrosis of the femoral head [n= 89] had been the main form of hip involvement.This study shows the high variety of rheumatism diseases in Black Africa

[Topographic patterna of osteoarthritis of appendicular joints in patients attending a teaching hospital clinic]

Determine the prevalence and topographic patterns of osteoarthritis. Medical records of patients seen at the Lome Teaching Hospital rheumatology clinic [logo] were studied retrospectively. Among the 12251 patients seen over a 15 year period, 1085 had appendicular osteoarthritis. Mean age at onset was 50, 3 years [extremes: 7 and 85 years], and mean duration of osteoarthritis was 4, 4 years. Principal distribution of affected joints was as follows: knee, 993 patients [844 females, 85%; 149 males]; hip, 77 patients [primary osteoarthritis: 36 patients, secondary osteoarthritis: 41 patients]; scapulohumeral joint, 5 patients; and fingers, 5 patients. At the knee, the lesions involved the medial femorotibial compartment in 493 patients [unilateral: 117 patients, bilateral: 376 patients], the lateral femorotibial compartment in 223 patients [unilateral: 74 patients, bilateral: 149 patients] and the patellofemoral compartment in 42 patients [unilateral: 17 patients, bilateral: 25 patients]. Mean age at onset of knee osteoarthritis was 50, 3 years. Among females with knee osteoarthritis, 83%were obese and 63, 5%had varus or valgus deformities. This study confirms that in black Africa the high prevalence of knee osteoarthritis contrasts with the low prevalence of primary osteoarthritis of the hip and of osteoarthritis of the fingers. Female sex, obesity, and varus or valgus deformities are the main risk factors for femorotibial osteoarthritis in black Africa