[Surgical treatment in De Quervain's tenosynovitis. About 20 cases]. / Traitement chirurgical de la ténosynovite de De Quervain. A propos de 20 cas.

INTRODUCTION: The De Quervain's tenosynovitis is an inadequacy into the first extensor compartment between the osteo-fibrous tunnel and the tendons. This mechanical conflict generates a tenosynovitis of the extensor pollicis brevis and the abductor pollicis longus tendons in first dorsal extensor compartment of the wrist. PATIENTS AND METHODS: The authors report a retrospective study of 20 patients who have been treated by a longitudinal surgical approach. The mean age was 49 years old with a net female predominance. The Finkelstein's test was positive in all cases. All patients were treated operatively by incision of the sheath, which was sufficient to unwind the dorsal compartment tendons. The sheath palmar flap has been sutured with skin (Le Viet plasty) to avoid a further tendons luxation. RESULTS: At three years follow-up, the functional results were good in all the patients. However, non-aesthetic scars were noticed in three patients. We did not notice neither a case of anesthesia of the radial nerve nor a tendinous luxation in our series. DISCUSSION: The stenosing tenosynovitis of the first dorsal extensor compartment of the wrist is a relatively frequent pathology in the young woman. We use a longitudinal surgical approach to avoid the radial nerve lesions. Le Viet procedure using the palmar flap of the pulley fixed to the dermis works as a barrier and maintains the tendons sliding on the radial styloid groove.

[Emphysematous pyelonephritis: radiologic diagnosis]. / Pyélonéphrite emphysémateuse: diagnostic radiologique.

Emphysematous pyelonephritis (EPN) is a rare and severe form of acute pyelonephritis. Escherichia coli accounts for 60% of the cases. Predisposing factors are: diabetus mellitus, recent urinary tract infection and obstruction. There is a female predominance (2/1). Conventional radiography reveals the renal emphysema in 85% of the cases. Ultrasonography shows hyperechoic areas corresponding to the gaz. CT scan is the best technique, allowing the exact localization of the gaz inside the renal parenchyma. The natural course of the disease allows its radiologic classification in 4 grades. EPN has a poor prognosis if only a medical treatment is initiated. Every urinary tract infection, in a diabetic patient must be treated, and must lead to a radiologic exploration, which allows an early detection of severe forms of the disease.

[Hydatid cyst of the mediastinum: 2 cases]. / Kyste hydatique du médiastin. A propos de 2 cas.

Hydatid cysts of the mediastinum are very uncommon. We report two cases of mediastinal hydatic cyst. The first case was located in the cardiophrenic recess while the other was within both the heart and mediastinum. A review of the imaging findings and value of various techniques is presented.

[Cystic meningioma. Apropos of 6 cases]. / Méningiomes kystiques. A propos de six cas.

We report six cases of meningioma, uncommon tumors which accounted for 2.7 of all meningiomas observed in our series. Computed tomography was performed in all patients and produced the diagnosis in only 40% of the cases. Surgical treatment was given. Histological examinations of the surgical specimens confirmed the diagnosis. CT and magnetic resonance imaging were sometimes misleading, suggestive of metastasis or glioblastoma. Selective carotid arteriography with opacification of the external carotid artery established the diagnosis. Prognosis was good after surgery.

[Ultrasound signs of pseudoneoplastic forms of hepatic hydatid cysts. A prospective analysis of 50 cases]. / Sémiologie échographique des formes pseudotumorales du kyste hydatique du foie. Etude prospective de 50 cas.

Pseudoneoplastic hydatid cyst of the liver (type IV), still raises diagnostic difficulties on ultrasonography (US), and often leads us to perform computed tomography. We therefore, conducted a prospective study of 50 cases of hepatic hydatid cyst (HHC) type IV in order to define the US and Doppler features allowing easy diagnosis with the best cost-effectiveness ratio. HHC type IV represented 23.7% of all types. The average age was 43.5 years with a female predominance. Many signs were described and their frequency was established. The main signs were daughter cysts (82%), hypo or hyperechoic spirals (66%), and peripheral transonic collarette (54%). At least one of these signs was present in 90% of cases. The Doppler study showed the avascular nature of the lesion in 100% of cases. Hydatid serology using modern immunologic techniques confirmed the diagnosis in 74% of cases. The US-serology combination can establish the positive diagnosis of HHC type IV in 94% of cases. Computed tomography therefore has a small place in this setting.

[Splenic tuberculosis. Apropos of 12 cases]. / La tuberculose splénique. A propos de douze cas.

Tuberculosis of the spleen is not exceptional. The authors report ten cases which occurred with a predominance in young male adults. All patients had at least one other site of tuberculosis, without any HIV infection. All patients had focal splenic lesions in the form of scattered hypoechogenic and hypodense nodules. These nodules had a pseudo-tumor appearance in one case. CT-guided puncture was performed in one case. Splenic tuberculosis is not as rare as is sometimes thought. The CT-guided splenic puncture is now performed routinely and remains the ideal diagnostic approach.

[Complete evacuation of a hydatid cyst of the liver into the common bile duct]. / Evacuation complète d'un kyste hydatique du foie dans la voie biliaire principale.

The authors report an exceptional case of hydatid cyst of the liver totally evacuated into the common bile duct. This rare complication of hydatid cyst of the liver was suspected clinically in a context of cholangitis, in a patient with hydatid cyst of the liver. The diagnosis of the cysto-biliary communication was based on several radiological examination, especially ultrasound examination which, when a large window setting is used, reveals the presence of hydatid material inside the dilated bile-ducts, and biliary opacification which locates the obstacle in the bile-duct and visualizes the cysto-biliary communication.

[Radiological aspects of vertebro-medullary hydatid cysts. Apropos of 12 cases]. / Aspects radiologiques de l'hydatidose vertébro-médullaire. A propos de 12 cas.

Twelve cases of vertebro-spinal hydatidosis were reviewed, over nine years period, to specify its clinical and histological characters. This localization, although rare, is the most common of the bone hydatidosis (44%). The authors develop the imaging methods contribution in positive and differential diagnosis, and underline the modern methods interest (CT scan, MR imaging) notably in spreading assessment and medical supervision.

[Radiological aspects of ileocecal tuberculosis. Apropos of 31 cases]. / Aspects radiologiques de la tuberculose iléo-caecale. A propos de 31 cas.

The radiological diagnosis of ileo-cecal tuberculosis is based on the analysis of various and polymorph semiological signs. The authors report a series of 31 cases of ileo-cecal tuberculosis. The concomitant involvement of the ileum and the cecum il up to 61.2% of all cases. The associated peritoneal involvement is observed in 35.4% of the cases. The hypertrophic form is the most common (57%) and the ulcero-hypertrophic form in 43% cases. The observation of ileum short stenosis, valve attempt, cecum retraction, and associated peritoneal involvement is in favour of the ileo-cecal tuberculosis origin.

[Unusual sites of Pott's disease. Apropos of fourteen cases]. / Localisations inhabituelles du Mal de Pott. A propos de quatorze cas.

The diagnosis of Pott's disease is generally easy exception unusual sites whose diagnosis is requires cross-section imaging and needle biopsy. The authors report 14 cases of atypical forms of Pott's disease: 7 cases of centro-somatic forms 4 cases of sub-occipital Pott's disease, 2 cases of posterior arch and one case of sub-ligamentous vertebral tuberculosis. The radiological diagnosis of Pott's disease is suggested by the presence of a paravertebral abscess noted in 12 cases tuberculous spondylitis associated in 3 cases and multifocal involvement in 9 cases.