[Exploration of infertility: correlation hysterography hysteroscopy]. / Exploration de l'infertilité: Corrélation hystérographie hystéroscopie.

BACKGROUND: In literature, a uterine lesion in found in half of the infertile women. AIM: To compare the results of the hysteroscopy and the hysterosalpingography in the study of the uterine cavity as exploration of feminine infertility. METHODS: Retrospective study, over a period of four years from 1 January 2005 to 31 December 2008 however, on 140 cases of infertile patients explored in the gynecology obstetrics department in Mahmoud El Matri hospital. RESULTS: Compared with hysteroscopy, hysterography had an overall sensitivity of 76.56%, a specificity of 77.63%, a PPV of 74.24%, an NPV of 79.72% and a very strong correlation with coefficient of 0.83. Best correlations between the two examinations were found with polyps, fibroids and synechia. CONCLUSION: Hysterosalpingography remains the first line examination in the exploration of feminine infertility. However, hysteroscopy must be realized as a second examination in case of lesions found at the hysterography or at once in certain cases.

Selective salpingography and tubal catheterization in infertile women.

BACKGROUND: Use of selective salpingography (SS) and fallopian tube catheterization (TC) has revolutionized the diagnosis and treatment of proximal tubal infertility. AIM: To evaluate results of women treated for proximal tubal obstruction by selective salpingography and tubal catherization. METHODS: Selective salpingography was performed in women with proximal bilateral tubal obstructions. Follow-up ranged from 4 to 12 months. RESULTS: twelve patients had been shown to have bilateral proximal obstruction of the fallopian tube. After SS/TC, patency was achieved in 8 cases. Spontaneous conceptions occurred in 4 women. CONCLUSION: SS and TC should be used more widely because it is simple and effective in case of proximal tubal blockage.

Maternal and fetal outcomes of large fetus delivery: a comparative study.

AIM: To review the deliveries of macrosomic babies, weighing over than 4000g and their obstetrical and neonatal outcomes. METHODS: Retrospective study involving a total of 209 deliveries at term of macrosomic babies between Marsh 2006 and February 2007 in the Maternity Hospital of Mahmoud ELMATRI, Tunis. The study concerned risk factors, mode of delivery and the incidence of maternal and perinatal complications.We compared data in the study group to a control group of normal weight infants delivered at the same period. RESULTS: Macrosomia occurred in 9.2% of all deliveries. The main risk factors of macrosomia were maternal age over 30 years (p=0,017), multiparty (p<0.001), diabetes mellitus (p=0.012) and prolonged term of delivery (p=0.02). These risk factors were statistically significant compared to control group. Caesarian delivery was achieved in 24.4% in macrosomy group and in 13.7% in control group (p=0,003) the major part occurred during labor. Among vaginal deliveries in macrosomia group, shoulder dystocia was noted in 1,9%, fetal respiratory failure and admission in intensive care unit was noted in 4,8% of the cases and hypoglycemia complicated 15,8% of deliveries. Maternal complications were dominated by post partum hemorrhage documented in 1.2% of the cases and perineal tears noted in 8,2% of vaginal deliveries. CONCLUSION: Vaginal delivery is the most frequent mode of delivery for a fetus weighing in excess of 4 kg and vaginal delivery should be attempted in the absence of contraindications and there is no need for elective systematic caesarian. However, shoulder dystocia remains the main complication of vaginal delivery for macrosomic fetuses and requires experienced obstetricians to manage these deliveries.

[Prenatal diagnosis and management of fetal megacystis]. / Conduite à tenir devant la découverte anténatale de mégavessie.

BACKGROUND: Prenatal diagnosis of fetal megacystis particularly in the first trimester requires assessement of pronostic and aetiologycal criteria. AIM: Report a new case. CASE: we report a case of severe megacystis in female fetus diagnosed at 23 weeks of gestation. There are no other associated ultrasound findings. Fetal karyotyping was normal (46XX). Termination of pregnancy for medical indications was realised because of progressive enlargement of the fetal bladder. Post-mortem examination shown megacystis-microcolon-intestinal hypoperistalsis syndrome. CONCLUSION: Fetal megacystis is a severe condition when diagnosed early in pregnancy. Ultrasonography follow-up and fetal karyotyping are important to evaluate prognosis.

[Utility of joint distension during arthrography in treatment of adhesive capsulitis of the shoulder in a study of 20 patients]. / Apport de l'arthrodistension dans le traitement des capsulites retractiles de l'epaule: a propos de 20 cas.

AIM: The aim of our study is to evaluate the efficacy of joint distension during arthrography followed by an intra articular corticosteroid injection. METHODS: This procedure associated to a physical therapy started immediately after joint distension and performed during 3 months in the treatment of 20 patients suffering from adhesive capsulitis of the shoulder were assessed. RESULTS: Patients were evaluated on D 90:90 % of them have regression of pain, 70 % have an improvement of deficiency and ranges of motion of the shoulder. Adhesive capsulitis of the shoulder is a disabling pathology but, generally, with good evolution. It is a clinical diagnosis. CONCLUSION: Joint distension associated to physical therapy has an interest in treatment because of therapeutic and antalgic effect and also restoration of range of movement.

[Antenatal diagnosis of multicystic renal dysplsia. Report of 11 cases]. / Diagnostic antenatal des dysplasies renales multikystiques. A propos de 11 cas.

BACKGROUND: Multicystic dysplastic of the kidney (UCDK) in the most common cause of an abdominal man in the new born period and is the most common cystic malformation of the kidney in infancy. The increasingly widespread use of prenatal diagnostic techniques has revealed that UCDK is apparently even more prevalent than had been assumed. THE AIM: of this study was to assess the utility of antenatal ultra ecography for in utero diagnosid of UCDK and its management. METHODS: A retrospective study of 11 UCDK cases diagnosed by antenatal ultra echography performed between the 4th and 6th monts of pregnancy. The outcome measure was radiographic imaginy It acts of a retrospective study of the 11 cases of DRMK diagnosed in anténatal by an echography obstétricale of the second quarter. A diagnostic confirmation was obtained by radiological examinations in post native for the pregnancies carried. RESULT: Patients with UCDK have significant associated urological and/or non urological malformations. In certain cases of non lethal anomalies, antenatal detection may influence both obstetric and postnatal management. Conservative management requires appropriate investigation of urinary tract tract and long-term follow-up.

Cervical spondylolysis: a case report.

Cervical spondylolysis is defined as a corticated cleft between the superior and inferior articular facets of the articular pillar, the cervical equivalent of the pars interarticularis in the lumbar spine. Of primary importance is its recognition to avoid confusion with more clinically significant abnormalities such as fracture or dislocation. This case report describes bilateral spondylolysis and associated dysplasia of C5 in a 31-year-old female. We describe the radiographic presentation of this anomaly, stressing the importance of computed tomography for correct diagnosis. A review of the literature on this interesting abnormality and a complete differential diagnosis are presented.

[Imaging cardiac hydatid cysts: 8 cases]. / Imagerie du kyste hydatique du coeur. A propos de 8 observations.

BACKGROUND: Early diagnosis of cardiac echinococcosis is required because this uncommon disease may lead to serious complications. We report 8 cases of cardiac hydatidosis, review the modes of diagnosis, and stress the contribution of modern imaging techniques. METHODS: This retrospective study describes 8 patients with cardiac echinococcosis. All had chest radiographs and thoracic computed tomography (CT). Transthoracic sonography was performed in 6 cases and magnetic resonance imaging (MRI) in 5. RESULTS: Our patients ranged in age from 7 to 46 years, and the clinical features of their disease varied. Chest radiography showed the contours of the heart to be deformed in 3 cases and cardiomegaly in 3 others. Echocardiography revealed a homogeneous unilocular hydatid cyst in 5 cases. CT found homogeneous hypodense unilocular lesions in 7 cases, and a septated cyst with cardiac wall calcifications in one case. MRI showed round homogeneous lesions in 3 cases, all dark in T1-weighted sequences and bright in T2. DISCUSSION: Clinical features vary substantially, and clinical latency is not uncommon. Chest radiography generally shows mediastinal masses. Transthoracic echocardiography can locate and count cardiac hydatid cysts and identify their borders. CT can simultaneously assess any visceral extension of the disease, while MRI provides details of mediastinal extensions. CONCLUSION: Transthoracic echocardiography suggests the initial diagnosis. CT and MRI provide details of the location and extension of the cardiac hydatidosis.

Elastofibroma dorsi: A report on 6 cases.

Elastofibromas are slow growing fibroblastic proliferations, which occur mainly in elderly women. They are typically located in the right subscapular region and are usually asymptomatic. The characteristic findings in ultrasonography, computed tomography and magnetic resonance imaging usually allow to make the diagnosis. We report six cases of elastofibroma dorsi, the clinical presentation and radiology findings are reviewed and compared with literature.

[Retroiliac ureter imaging. A case report]. / Apport de l'imagerie dans l'uretère rétroiliaque. A propos d'un cas.

The retroiliac ureter is a rare congenital anomaly with no specific clinical and biologic signs. The authors reports a case of right retroiliac ureter diagnosed in a 41-year-old male with an isolated renal colic. Diagnosis was confirmed by abdominal CT-scan. The different investigations did not show other associated congenital abnomaly. Therapeutic decision was to establish a clinical, biologic and sonographic surveillance.

[The place of MRI in the hepatic tumors]. / Place de l'imagerie par resonance magnetique dans les tumeurs hepatiques.

MRI semeiology of hepatic tumors was assessed with a retrospective study of 132 patients explored between May 1998 and December 2001. MR examinations were acquired with a one Tesla operating system. All images were acquired by a T2-weighted fast spin echo MR and dynamic flash MR with Gadolinium. Hemangiomas demonstrate characteristic signs in most cases, as was described in the literature. However, adenoma, hepatocellular carcinoma and metastases have various and less specific features.

Primary leiomyosarcoma of bone: report of 4 cases.

Primary leiomyosarcoma of bone is a very rare tumor. Four cases are reported: 3 tumors were located in the femur and 1 in the talus. Clinical and imaging findings including radiographs, CT, and MRI are described. The final diagnosis was made by histopathological, immunohistochemical, and/or ultrastructural study after biopsy.

[Imaging of neuro-Behcet]. / Apport de l'imagerie au cours des manifestations neurologiques de la maladie de Behcet.

Behcet's disease is a vasculitis affecting predominantly the venous system. It's characterized by a classical triad of recurrent uveitis, oral and genital ulceration. Behcet's disease is more frequent in Japan, the Middle East and some Mediterranean countries. Its pathogenesis is still uncertain. Neurological manifestations in Behcet's disease are not rare and are associated with poor prognosis. These manifestations can be inaugural in 5% of cases and they are polymorphous. We report 15 new cases of neuro Behcet's disease explored by magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA).