[Osteoarticular infections due to Gram-negative bacilli]. / Les infections ostéo-articulaires à bacilles Gram négatif.

An enquiry carried out on 20 French rheumatology units led us to find, out of a total of 1,202 cases of non-tuberculous osteo-arthritis of the adult, 137 gram negative bacillary infections. These were 64 cases of spondylodiscitis and 73 cases of septic arthritis, due mainly to Escherichia Coli, Pseudomonas and other enterobacteria. The frequency of gram-negative bacilli was 11.4% i.e. 9.2% in the case of arthritis and 15.6% in the case of spondylodiscitis. It is higher than in the middle of this century but does not seem to be progressing now. However, the seventy of this type of infection, which may cause important functional sequelae and numerous deaths (8 patients) justifies the routine search for these bacilli in appropriate culture media, in order to test their sensitivity to antibiotics.

[Non-tuberculous infectious coxitis in adults]. / Les coxites infectieuses non tuberculeuses de l'adulte.

A multicentric study permitted us to report 94 cases of non-tuberculous infections of the hip joint in the adult (13.4% of the cases of septic arthritis observed over the same period). A local predisposing factor (37.2%) and/or general predisposing factors (22.6%) were frequently noted. The routine search for bacteria permits identification of the latter in 71.3% of cases; the germ was usually a staphylococcus, arthritis due to Gram negative bacilli were found in 12% of the cases. The authors emphasize the interest of daily joint aspiration and traction on the lower limb associated with bactericidal antibiotic therapy which are the only means able, in their view, to improve the poor functional prognosis in these cases of hip joint infections.

[Value of myeloscintigraphy in the detection of intraspinal compressions]. / Intérêt de la myéloscintigraphie dans le dépistage des compressions intrarachidiennes.

The authors report their experience of myeloscintigraphy summarizing the 120 examinations made during the years 1975 and 1976, in the department of rheumatology of the regional hospital centre of Clermont-Ferrand. The technique uses serum labelled with technetium 99 introduced by the lumbar route. Schematically 3 pathological patterns can be determined : complet block, segmental block, and partial block. The examination is particularly reliable at the dorsal and high lumbar levels, where only one "false negative" was found, and even that debatable. In this situation it has a valuable role in regard to both the presence and the level of a compression. In the cervical and low lumbar levels, its reliability seems definitely inferior, especially in the case of lateral disc herniations. Tolerance has always been excellent whatever the age of the patient. We have thus an investigation that is simple and well tolerated, and its valuable role in the early detection of myelo-radicular compressions should assure it a place of choice alongside other methods of paraclinical investigation of the spinal canal.