[Treatment of vascular pain of the face by methylprednisolone injection into the area of the greater occipital nerve: 16 cases]. / Traitement des algies vasculaires de la face par injection de methylprednisolone dans la région du grand nerf occipital: 16 cas.

Sixteen patients suffering from cluster headache received an injection of 160 mg methylprednisolone into the region of the greater occipital nerve ipsilateral to the pain, when free of headache. In episodic cluster (n = 8), attacks ceased in 2 cases and decreased in severity and frequency in one other. Three patients failed to respond at all. Two became headache-free, but the injection had possibly been performed towards the time when the episode might have been expected to end spontaneously. In chronic cluster (n = 8), four patients failed to respond at all. Four others improved, but only partially and transiently. On the whole, the present results are not as favourable as those obtained by Anthony, who advocated this technique.

[Expression of pain in rheumatic disease. Exploratory study]. / L'expression de la douleur en rhumatologie. Etude exploratoire.

An investigation done in 34 rheumatology departments on 259 patients in order to analyse their perception of pain and its repercussions on daily living. The main three diseases justifying hospitalization are: rheumatoid arthritis, lumbosciatica and bone neoplasia. In these patients, pain occurs daily in 75 p. cent of them and continuous in 32 p. cent; the intensity of the pain varies according to the time. There are repercussions on work (63 p. cent), walking (81 p. cent), but also on leisure (74 p. cent), friendly interelations (42 p. cent) and disposition which is disturbed in 62 p. cent of patients. Behavioral analysis in the presence of pain brings up differences depending on the patients: the elder the patient, the least they are able to respond to the handicap caused by pain. Analysis of the pain vocabulary suggest that if the terms expressing the experience of the patient are different according to the diseases, the usual description of painful phenomena are common to patients and the diseases in question.

[Systematic ileocolonoscopy in seronegative spondylarthropathies]. / Iléocolonoscopie systématique au cours des spondyloarthropathies séronégatives.

An inflammation of the ileum was observed by Mielants and Veys in patients suffering from reactional arthritis associated to HLA B27 antigen. We thought it would be interesting to perform a systematic ileo-colonoscopy in patients suffering from seronegative spondylo-arthropathy, whether it was an axial or a peripheral form of the disease, or it was associated or not to HLA B27 antigen. The results observed in 30 patients who responded to the criteria of Wright and Moll for the diagnosis of seronegative spondylo-arthropathy, were compared to those of 18 patients suffering from various gastro-intestinal disorders. Macroscopically, a minimal abnormality (erythematous patches and/or micro-ulcerations) was observed in 10 out of 30 patients, and never in the reference group (p less than 0.02). The histological examination demonstrated, in patients suffering from spondylarthritis, a higher frequency of minimal signs of inflammation (lympho-plasmocytes infiltration) at the level of the ileum (in 18 out of 19 patients versus 11 out of 18 patients in the reference group, p less than 0.05) and at the level of the rectum (in 15 out of 19 patients, versus 8 out of 17 patients in the reference group, p less than 0.05). This study suggests therefore the presence of minimal ileorectal inflammation in patients with seronegative spondylo-arthritis, which could have an influence on the pathogenesis and/or the evolutive course of the disease.

[Myasthenia induced by D-penicillamine during the treatment of rheumatoid polyarthritis]. / Myasthénie induite par la D-pénicillamine au cours du traitement de la polyarthrite rhumatoïde.

Seven cases of myasthenia induced by D-penicillamine treatment of rheumatoid arthritis are presented. The 86 cases published so far are reviewed. The clinical symptoms do not differ from those of the idiopathic form. Progress is rapid and, generally, good. The duration and dosage of the treatment are not involved. The presence of acetylcholine-antireceptor antibodies confirms the autoimmune origin of the condition. Possible mechanisms by which this disorder could be induced are discussed. Investigation of HLA phenotypes suggests that the genetic basis of induced myasthenia differs from that of the idiopathic form (increased prevalence of DR1).

[Mycobacterial infection of the hip following total prosthesis. Study of 6 cases]. / L'infection mycobactérienne de la hanche après prothèse totale. Etude de 6 cas.

The authors present 6 cases of mycobacterial infection of the hip after total hip replacement: 5 cases of tuberculosis and 1 case of Mycobacterium fortuitum infection. They emphasise the clinical, radiological, bacteriological and histological signs which are generally very characteristic and unequivocal. A review of the literature reveals the rarity of these infections, but stresses the need for a complete bacteriological survey to avoid missing the diagnosis. A routine medicosurgical therapeutic approach is proposed.

Polyarteritis nodosa associated with biclonal gammopathy of two-cell line origin and amyloidosis.

A patient suffering from polyarteritis nodosa associated with a biclonal gammopathy with amyloidosis was studied to investigate the role of the paraproteins in the production of vascular lesions. The use of specific antiidiotypic antibodies allowed comparison of the variable regions of the two M-components and investigation of their cellular origin as well as their presence in vasculitis lesions. No idiotypic determinant shared by the 2 molecules was found and these paraproteins were found to be secreted by 2 different cell lines. In contrast with the presence of polyclonal immunoglobulins and complement, the paraproteins were absent in damaged arterial walls. These results indicate that the 2 diseases were independent.

[Systemic periarteritis nodosa associated with monoclonal gammapathy. 4 cases]. / Périartérite noueuse systémique associée à une gammapathie monoclonale. Quatre observations.

Four cases of monoclonal gammopathy associated with polyarteritis nodosa are reported. In view of the chronology of events and course of the disease, the connections between protein peak and polyarteritis nodosa can be considered. Management of polyarteritis nodosa is discussed according to the existence of a peak which may originate in myeloma. The part played by plasma exchanges is debated.

[Monoarthritis symptomatic of adjacent bone tumors. Study of 5 cases]. / Monoarthrites révélatrices de tumeurs osseuses de voisinage. Etude de 5 cas.

The authors present 5 cases of monoarthritis which revealed adjacent bone tumours: a bony metastasis, a fibrosarcoma and three bone lymphomas. In three cases, the synovial histology showed lesions of non-specific synovitis without neoplastic invasion. A review of the literature demonstrates the rarity of these mono- or oligo- arthrites adjacent to bone tumours and two types can be distinguished: neoplastic invasion of the synovium or reactive non-specific synovitis without invasion.