[Anatomo-pathological study of enthesopathies in inflammatory spondylarthropathies]. / Etude anatomo-pathologique des enthésopathies des spondyloarthropathies inflammatoires.

The authors report the pathological aspects observed in three peripheral entheses (spine of the scapula, talus and patella) of inflammatory spondylo-arthropathy (ISP). A mononuclear inflammatory infiltrate, more or less important, is found in all cases corroborating the rare findings in the literature. Until now, the anatomical study of ISPs was uneasy because of the difficult approach of the sacro-iliac joint and the spine due to their anatomical location. The present study, in spite of the small number of reported cases, proposes to show that inflammatory lesions may be studied in peripheral entheses which are more accessible to biopsies, and suggest the development, in the future, of a more minutious study of the different varieties of ISP.

[Sulfhydryl maintenance treatment in rheumatoid polyarthritis. A series of 120 cases followed for 10 years and a study of possibilities of changing the drug]. / Traitements de fond sulfhydrylés au cours de la polyarthrite rhumatoïde. Une série de 120 cas suivis pendant dix ans avec étude des possibilités de changement de médicament.

The authors present a series of 120 cases of sero-positive rheumatoid arthritis followed for ten years and treated with D-penicillamine, gold salts and pyrithioxine used either alone or sequentially after stopping one of these treatments because of failure, intolerance or escape. This series can be broken down as follows: 13% of patients are under treatment after ten years, 27% had a favourable result with one of the three treatments for five to ten years, 59% had a poor result (less than 5 years) or no effect. However, it appeared that a failure or an escape from one of these products did not signify a failure with another product and side effects did not necessarily recur with a change of treatment.

[Systematic research on enthesopathies in chronic rheumatism. Results and pathological significance. Relation to erosive spondylitis and other tendinous or synovial lesions]. / Recherche systématique des enthésopathies au cours des rhumatismes chroniques. Résultats et signification pathologique. Rapport avec la spondylite érosive et les autres lésions tendineuses ou synoviales.

A routine investigation for rheumatic tendon lesions was conducted in 47 patients with an inflammatory spondylo-arthropathy and in 30 patients with rheumatoid arthritis. The incidence of tendon lesions (calcaneal and extra-calcaneal) differed very significantly (p less than 0.001) between the two groups (58.3% of patients with inflammatory spondylo-arthropathy had at least one tendon lesion, 6.6% of patients with rheumatoid arthritis). These results and data from the literature suggest that rheumatic tendon lesions are a characteristic feature of spondylo-arthropathy in the same way as sacro-iliitis, the absence of subcutaneous nodules, the absence of rheumatoid factor and the high incidence of histocompatibility antigen HLA B27. Together with this diagnostic value, there is also a histopathological value: inflammatory and ossifying tendinitis contrasts with the destructive synovitis of rheumatoid arthritis and can be considered to be a "sign" of inflammatory spondylo-arthropathy. Tendinitis and juxta-articular bone lesions in the limbs, so-called "peripheral" lesions, are similar to the vertebral lesions around the intervertebral disk and the posterior interapophyseal joints found in inflammatory spondylo-arthropathy. These lesions seem to be a common pathological feature, at least in part, with the polyarthropathies of childhood.

[Association of ankylosing spondylarthritis, cauda equina syndrome and dilatation of the lumbar cul-de-sac with voluminous arachnoid diverticulum. Clinical, radiological and tomodensitometric study of a case]. / Sur l'association spondylarthrite ankylosante, syndrome de la queue de cheval et dilatation du cul-de-sac lombaire avec volumineux diverticule arachnoïdien. Etude clinique, radiologique et tomodensitométrique d'un cas.

The authors report a clinical and radiological observation of cauda equina syndrome associated with ankylosing spondylitis. Although only 32 cases have been reported in the literature over the last twenty years, such an association is probably not exceptional. The mode of onset and the course of the neurological symptoms is quite similar from case to case: ankylosing spondylitis preexisting for many years, and inactive when neurological signs develop, the latter usually being very slowly progressive. The usual radiological features, demonstrated by saccoradiculography in the supine position, are posterior diverticulas of the lumbar theca, contiguous to bony erosions of the laminae, well visualized by computed tomography. Pathogenesis remains obscure, and none of the attempted therapies, including surgical procedures, have proved effective.