Scintigraphie osseuse trois temps dans la caractérisation de l'ostéonécrose aseptique de la tête fémorale / Three-stage bone scintigraphy in the characterization of aseptic osteonecrosis of the femoral head

Objectifs. Déterminerla place de la scintigraphie osseuse 3 temps dans le diagnostic del'ostéonécrose avasculaire de la tête fémorale (OATF).Matérielset Méthode. Nousavons colligérétrospectivement62 scintigraphies osseuses (SO+)mettant en évidence uneOATF. Ces SO+ ont été réalisées au Service de Médecine Nucléaire du CHU YOde Ouagadougou,de 2017à 2022. Un formulaire de recueil de données a permis de collecter les données générales et les résultats de la scintigraphie osseuse. L'étude descriptive consistait à calculer les fréquences pour les variables qualitatives et les moyennes pour les variables quantitatives.La SO en trois temps a été faite chez tous les patients après injection de 296 à 925 MBq d'un dérivé diphosphonate : l'hydroxyméthyléne diphosphonate(HMDP) marqué au technétium 99 m (Tc99m). Résultats. 62patients ont présenté une SO+ à la recherche scintigraphique de l'OATF de 2016 à 2021. Leur âge moyen est de 35 ± 14,18 ans avec une nette prédominance féminine (75,8%). La principale étiologie retrouvée etaitla drépanocytose. La douleur coxale avec ou sans boiterie a indiquéla réalisation de la SO dans 41,66 % des cas. Lesvingt-cinqpatients (40,3%) qui avaient bénéficié d'une TDM de la hanche concernée ont été adressés pour confirmation du diagnostic (n=4), bilan pré opératoire (n=9), recherche d'autres foyers(n=12). Pour lesonzepatients atteints de pathologie cancéreuse,le diagnostic d'OATF était fortuit au décours d'une SO réalisée dans le cadre de leur bilan d'extension. Sur les images scintigraphiques tardives, les atteintes de type II de GOLLSHALK étaient majoritaires,suivies des atteintes de type III puis de type I. Il n'y avait pas d'atteinte de type IV. Conclusion. La SO est efficace dans la caractérisation de l'OATF avant l'apparition de la symptomatologie clinique et de la traduction radiologique. Lorsque l'IRM est disponible et n'est pas contre indiquée, la SO est la modalité diagnostique à utiliser en deuxième intention.

Objective: Determine the role of three-step bone scintigraphy (BS) in the diagnosis of aseptic osteonecrosis of the femoral head (AOFH).Materials and Method: Retrospectively we collected 62 positive bone scans (BS+) at aseptic osteonecrosis of the femoral (AOFH). These BS+ were carried out at the Nuclear Medicine Department of CHU YO, from 2017 to 2022. A data collection form has been prepared. It made it possible to collect general data and the results of the bone scintigraphy. The descriptive study consisted of calculating the frequencies for the qualitative and the the means for the quantitative variables. The three-step BS was performed in all patients after injection of 296 to 925 MBq of a diphosphonate derivative: hydroxy methylene diphosphonate (HMDP) labeled with technetium 99 m (Tc99m).Results: 62 patients were positive (BS +) in the aseptic avascular osteonecrosis of the femoral head scintigraphic research from 2016 to2021. Their average age is 35 ± 14.18 years with a clear female predominance (75.8%). The main etiology fremains sickle cell anemia. Hip pain with or without lameness indicated the realization of SO in 41.66% of cases. The twenty-five patients (40.3%) who had undergone CT of the affected hip were referred for confirmation of the diagnosis (n=4), preoperative workup (n=9), search for other foci (n=12). For the eleven patients with cancerous pathology, the diagnosis of AOFH was fortuitous after an BS performes as part of their extension workup. On the late scintigraphic images, type II involvement of GOLLSHALK was predominant, followed by by type then type I. There was no type IV involvement. Conclusion: BS is sensitive in the detection of aseptic avascular osteonecrosis of the femoral head before the onset of clinical symptoms and radiological translation. When MRI is available and not contraindicated, BS is the second-line modality

Epidemiology of rheumatic diseases: a cohort of 23,550 patients in rheumatology clinics in Burkina Faso.

OBJECTIVE: The aim of this work is to study the epidemiological characteristics of rheumatic conditions in a cohort of 23,550 patients followed up in Ouagadougou, Burkina Faso. PATIENTS AND METHODS: This was a descriptive observational study on records conducted from February 2006 to December 2019 in Ouagadougou (Burkina Faso). All patients seen in rheumatology consultation in the city of Ouagadougou were included. The diagnosis of mechanical and degenerative osteoarthropathies was based on clinical and radiological findings; osteoarticular infection was based on clinical and biological findings. The diagnosis of gout was based on the clinical findings, uricemia, and/or the presence of sodium urate crystals in the synovial fluid on microscope. The diagnosis of rheumatoid arthritis and systemic lupus erythematosus was based on the ACR/EULAR criteria. RESULTS: In total, 23,550 patients were included in the study. These were 14,995 female patients (63.70%) and 2555 male patients (36.30%). The average age of patients was 49.61 ± 15.36 years with extremes of 9 months to 120 years. Degenerative osteoarthropathies were the most common presentation (13,377 patients; 59.35%) followed by tendinopathies (2199 patients; 9.34%); chronic inflammatory rheumatism was in third place (841 patients; 3.57%) led by rheumatoid arthritis (434 patients); 51.61% of chronic inflammatory rheumatism, systemic lupus erythematosus and ankylosing spondylitis accounted for 71 patients (0.4%) and 63 patients (0.27%), respectively. CONCLUSION: The epidemiology of rheumatic conditions is characterized by its diversity in hospital setting. The scarcity of some conditions such as systemic lupus erythematosus, psoriatic arthritis, and ankylosing spondylitis has been confirmed in this cohort. Key Points • Twenty-three thousand five hundred and fifty patients were included in the study • Rheumatoid arthritis was the most frequent (51.61%) chronic inflammatory rheumatism • Contrary to studies from Europe and America, systemic lupus seems rare in our series.

KINESIOPHOBIA: FREQUENCY, ASSOCIATED FACTORS AND IMPACT ON THE LIFE QUALITY OF PARTICIPANTS WITH CHRONIC LOW BACK PAIN IN SUB-SAHARAN AFRICA.

OBJECTIVE: The aim: To study the frequency of kinesiophobia, the associated factors and its impact on the life quality in black Africa of participants with chronic low back pain. PATIENTS AND METHODS: Materials and methods: It was a cross-sectional, descriptive and analytical study, conducted over the period extending from March 2019 through September 2019. The study population included all black African participants with chronic low back pain who were seeking care at the rheumatology and physical medicine departments, during the study period. Pain intensity, duration of symptoms, medical history, endurance of trunk muscles, kinesiophobia index, and quality of life were assessed. We used the Visual Analog Scale (VAS) to measure pain intensity, the Shirado-Ito and Sorensen tests to assess trunk muscles endurance. The kinesiophobia index, as well as its impact on life quality were measured using the "Tampa Scale for Kinesiophobia" (TSK), and the Dallas Auto-Questionnaire (D.R.A.D) scale for spine Pain respectively. RESULTS: Results: One hundred and twenty patients were involved. Eighty-five patients (70.83%) had kinesiophobia. The factors associated with kinesiophobia included pain intensity (p = 0.0006); duration of symptoms (p = 0.027); hypertension (p = 0.03). Loss of endurance in trunk muscles, weight and gender were not found to be factors associated with kinesiophobia. Based on the DALLAS self-questionnaire, the quality of life was altered. CONCLUSION: Conclusions: Kinesiophobia was a recurrent disease. It was associated with the presence of hypertension, the intensity of pain, the duration of the low back pain with an impairment in quality of life.

Place de l'échographie dans la prise en charge de la scapulalgie en rhumatologie à l'hôpital de Dreux / Place of ultrasound in management of shoulder pain in the Rheumatology Department of Dreux Hospital

Contexte & objectif. Les données sur la prise en charge des épaules en rhumatologie sont très limitées. L'objectif de la présente étude était de décrire la place de l'échographie dans la prise en charge des épaules douloureuses en rhumatologie. Méthodes. C'était une étude transversale sur les scapulalgies, suivies en rhumatologie de l'hôpital de Dreux ; entre janvier et mars 2018. Tous les participants avaient réalisé une échographie. Résultats. Au total 40 patients ont été enrôlés. Leur âge moyen était de 61,7 ans, et le sex ratio M/F de 0,29. A l'examen clinique, un conflit sous acromial (67,6%) et un syndrome acromio-claviculaire (32,4 %) étaient souvent observés. Les manœuvres de Jobe (76,5%), Patte (20,6%), et Gerber (14,7%) étaient parfois positives. A l'échographie, on observait les lésions des tendons de la coiffe (82,5%), du long biceps (25%), une bursite sous acromio-deltoïdienne (BSAD : 55%), une arthropathie gléno-humérale (30%), acromio-claviculaire (30%) ou sterno-claviculaire (2,5%). Une infiltration sous échographie était réalisée dans 85% des cas : BSAD (67,5%), gaine du long biceps (7,5%), articulation acromio-claviculaire (7,5%) et sterno- claviculaire (2,5%). Conclusion. L'échographie est très importante dans la prise en charge des scapulalgies dans le département de rhumatologie de l'hôpital de Dreux. Elle permet un diagnostic précis et la réalisation des gestes échoguidées.

Context and objective. Knowledge on management of shoulder pain is limited. The objective of the study was to describe the place of ultrasound in the management of shoulder pain in the Rheumatology Department of Dreux Hospital. Methods. A cross-sectional study was conducted on patients attending Rheumatology Department for shoulder pain from January to March 2018. All participants performed an ultrasound. Results. The mean age of the 40 patients included in the study was 61.7 years and the sex ratio was 0.29. On clinical examination, subacromial conflict (67.6%) and acromioclavicular syndrome (32.4%) were often observed. The Jobe (76.5%), Patte (20.6%), and Gerber (14.7%) tests were sometimes positive. Ultrasound lesions involved the rotator cuff (82.5%), subacromio-deltoid bursitis (55%), the long biceps tendon (25%), the glenohumeral joint (30%), the acromioclavicular joint (30%), or the sternoclavicular joint (2.5%). Ultrasound-guided infiltration was performed in 85% of cases. It concerned subacromio-deltoid bursitis (67.5%), long biceps sheath (7.5%), acromioclavicular joint (7.5%), and sterno-clavicular joint (2.5%). Conclusion. Ultrasound is very important in the management of shoulder pain in the Rheumatology Department of Dreux Hospital. It allows a precise diagnosis and the realization of echo-guided injections.