[A new case of sarcomatous degeneration of the spine in Paget's disease of bone]. / Nouvelle observation de dégénérescence sarcomateuse du rachis Pagétique

In referring to a personal observation the authors recall the rarity of malignant degeneration of lesions of the spine caused by Paget's disease. In the majority of cases these consist of multiple centred osteo-sarcomatosis. The lumbar spine is the most often affected. The clinical picture is essentially a syndrome of radiculomedullary compression. Rapid aggravation of the condition usually leads to a neurosurgical operation, which will confirm the existence of the osteo-sarcomatous process. The evolution is always fatal.

[Symptomatic and evolutive characteristics of articular destruction noted in chondrocalcinosis]. / Caractères symptomatiques et evolutifs des destructions articulaires observées au cours de la chondrocalcinose

Referring to 17 personal observations, the authors endeavour to clarify the main clinical and radiological traits of the destructive arthropathies occuring in patients suffering from diffuse, articular chondrocalcinosis. These arthropathies appear to be relatively frequent and older, obese women suffering from demineralization are more readily affected. The knees, coxo-femoral joints and the shoulders are principally concerned, and to a lesser extent the wrists, the trapezo-metacarpal joints and even the spine. The lesions can be polyarticular and symmetrical, be grouped in more or less random oligoarticular combinations or may occur in only a single joint space. Clinically, these destructive arthropathies give rise to severe pain and very marked functional impotence. The joints are swollen without any signs of inflammation. The joint movements are painful, stiff, and limited. Axial deviations are frequent. Radiologically, the lesions occur throughout the cartilage sheath, the inter-chondrial bone, and in the underlying epiphysary bone, in the form of massive geodes and massives loss of tissue substance. On the other hand, the process of reconstruction is very limited. In the patients studied, chondrocalcinosis was proved by the very characteristic pictures of calcic incrustations of the cartilage sheath and the fibro-cartilages, by the discovery of micro-crystals of calcium pyrophosphate in the articular fluid or, at biopsy, by the thickness of the synovial fluid. This chondrocalcinosis was primary in the cases. These destructive lesions were easily distinguishable from nervous or diabetic osteo-arthropathies, and from tumoral, infectious, rheumatic, or vascular changes. Thus, chondrocalcinosis is among the most common causes of osteo-articular destruction. It should be looked for systematically in all patients with lytic arthropathies of unknown etiology.