Translation, adaptation, and validation of the Moroccan version of the Roland Morris Disability Questionnaire.

STUDY DESIGN: Cross-cultural adaptation and cross-sectional psychometric testing. OBJECTIVES: To translate and culturally adapt the Moroccan version of the Roland Morris Disability Questionnaire and to validate its use for assessing disability in Moroccan patients with low back pain (LBP). SUMMARY OF BACKGROUND DATA: The RMDQ is a reliable evaluation instrument for LBP disability, but no validated Moroccan version is available. METHODS: The RMDQ was translated and back-translated to dialectal Arabic, pretested, and reviewed by a committee following the Guillemin criteria. It was then validated on 76 Moroccan patients with chronic LBP. Reliability for the 1-week test-retest was assessed using internal consistency by Cronbach's alpha coefficient, the intraclass correlation coefficient, and the constructed Bland Altman plot. Structure validity was evaluated by multiple correspondence analysis. External construct validity was assessed by association with pain, spinal mobility, and other key variables (weight, height, duration of LBP). RESULTS: The reproducibility of the 24 items was satisfactory with a kappa statistic of agreement superior to 0.6 except item 10 and ranging from 0.47 to 0.9. The intraclass correlation coefficient for global score reproducibility was good and reached 0.93 (95% confidence interval, 0.89-0.95). The constructed Bland and Altman plot for test-retest agreement showed a good reliability. The internal consistency was very good with a Cronbach's alpha coefficient of 0.96. The multiple correspondence analysis for internal structure validity showed a preponderant factor explaining 22% of the variance in the score. The construct validity showed a positive correlation between RMDQ and the visual analog scale (r = 0.32; P = 0.005). There was no statistic correlation between RMDQ and the other variables. CONCLUSION: The Moroccan version of the RMDQ has good comprehensibility internal consistency, reliability, and validity for the evaluation of Moroccan-speaking patients with LBP.

Maffucci's syndrome: a case report.

Maffucci's syndrome is a congenital nonhereditary syndrome characterized by a combination of enchondromatosis and hemangiomatosis. It is associated with an increased risk of malignancy. We report a case of a 24-year-old woman who developed severe bone distortion due to generalized enchondromas since the age of 2 years. Physical examination showed a marked shortening of both upper and lower limbs and cutaneous hemangioma in the legs. Radiological study showed symmetric well-circumscribed radiolucent cystic lesions in the hands and severe metaphysical irregularity and a shortening of all long bones. The biopsy of the third right metacarpal showed enchondroma tissue. Histological examination of the skin specimen showed a hemangioendothelioma. The diagnosis of Maffucci's syndrome was established. Abdominal ultrasound, mammography, cerebral computed tomography (CT) scan, and cervical CT were normal.

Spinal cord compression due to vertebral osteochondroma: report of two cases.

Osteochondroma, or exostosis, is the most common of all benign bone tumors. Spinal osteochondromas are uncommon but may cause neurological compromise. We report two cases of spinal cord compression by osteochondromas. One patient was a 17-year-old man with hereditary multiple exostoses who was presented with spastic paraparesis, a sensory level at T3-T4, and a pyramidal syndrome. Vertebral exostosis was suspected by magnetic resonance imaging and confirmed by histological examination. Surgical decompression was followed by complete resolution of the neurological impairments. The other patient was a 19-year-old man with spastic paralysis of the right lower limb and a pyramidal syndrome. Whereas magnetic resonance imaging suggested a neurofibroma, histological features were those of osteochondroma. Nine months elapsed from symptom onset to surgery. This delay led to residual neurological impairments, which resolved almost completely after rehabilitation therapy. Vertebral osteochondromas contribute only 1.3-4.1% of all osteochondromas. The lesion may be solitary or a manifestation of hereditary multiple exostosis. Magnetic resonance imaging shows the exact location of the lesion, most notably with relation to neighboring neurological structures. Spinal cord compression is uncommon and usually has a favorable outcome provided surgical decompression is performed before major neurological damage develops.