Revue du Rhumatisme Monographies最新文献_第6页

Reconnaître les signes de gravité systémique d’une infection ostéoarticulaire 识别骨关节感染的全身严重迹象

Revue du Rhumatisme Monographies Pub Date : 2022-02-01 DOI: 10.1016/j.monrhu.2021.11.001

Hélène Mascitti , Clara Duran , Frédérique Bouchand , Aurélien Dinh

{"title":"Reconnaître les signes de gravité systémique d’une infection ostéoarticulaire","authors":"Hélène Mascitti , Clara Duran , Frédérique Bouchand , Aurélien Dinh","doi":"10.1016/j.monrhu.2021.11.001","DOIUrl":"10.1016/j.monrhu.2021.11.001","url":null,"abstract":"<div><p>Bone and joint infection (BJI) are heterogeneous: acute infections, chronic infections, prothetic infections, osteomyelitis, diabetic foot infections... Acute infections are not diagnostic problems. <em>Staphylococcus aureus</em> is mostly involved and cause noisy clinical manifestation (fever, pain±functional impairment, redness, heat and edema). Chronic infections mainly concerned prosthetic joint infection and usually are not therapeutic emergencies but a diagnostic challenge. Indeed, the management of this type of infection combine prolonged antibiotic therapy (12weeks) with heavy operative procedure. Overall, BJIs very rarely show signs of systemic severity, however there are some elements of poor prognosis to be aware of. The SOFA quick score (qSOFA) can be used at bedside. This score includes the following clinical items: respiratory rate≥22 / min, upper function disorders, systolic blood pressure≤100 mmHg. A qSOFA score≥2 implicated a transfer in intensive care unit. The sepsis criteria were simplified in 2016 during the “Surviving sepsis campaign”. The new recommendations define sepsis as life-threatening organ dysfunction due to a dysregulated host response to infection. BJIs imply the functional prognosis but the risk of sepsis is low. Bacteriemia during BJIs occurs in 20% of cases. In case of sepsis during BJI, the probabilistic antibiotic therapy must include an anti-gram positive cocci. The involvement of methicillin-resistant <em>Staphylococcus aureus</em> and Ponto-Valentine <em>Staphylococcus aureus</em> in BJIs should be identified early in order to limit the consequences through appropriate aggressive medico-surgical management.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73628003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biopsies vertébrales assistées par robot dans les spondylodiscites infectieuses 机器人辅助椎体活组织检查感染性椎体炎

Revue du Rhumatisme Monographies Pub Date : 2022-02-01 DOI: 10.1016/j.monrhu.2021.10.004

Vincent Goëb , Jean-Marc Sobhy Danial , Martial Ouendo , Johann Peltier , Michel Lefranc

{"title":"Biopsies vertébrales assistées par robot dans les spondylodiscites infectieuses","authors":"Vincent Goëb , Jean-Marc Sobhy Danial , Martial Ouendo , Johann Peltier , Michel Lefranc","doi":"10.1016/j.monrhu.2021.10.004","DOIUrl":"10.1016/j.monrhu.2021.10.004","url":null,"abstract":"<div><p>The use of a vertebral biopsy remains very frequently relevant in the management of patients with infectious spondylodiscitis without identified germs or vertebral metastases without identified primary cancer in order to obtain bacteriological and/or histological proof of the disease. There are few Rheumatology departments which remain completely independent in carrying out these vertebral biopsies. We describe here a technique of spinal biopsies under robotic assistance. This aims to be more precise than current techniques, more comfortable for the patient, and to reduce the average length of stay of patients hospitalized in rheumatology. The biopsy is performed in the operating room by a rheumatologist/neurosurgeon duo guided by a robot. The precision of the biopsy is based on the acquisition of three-dimensional spinal anatomy by a plane sensor scanner coupled to the robot. This technique of vertebral biopsies is easily acquired and allows the rheumatologist to be independent from the first consultation to the aetiological diagnosis, then to the treatment of infectious spondylodiscitis. This technique is however dependent on the availability of an equipped operating theater.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90600515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physiopathologie des infections ostéoarticulaires 骨关节感染的病理生理学

Revue du Rhumatisme Monographies Pub Date : 2022-02-01 DOI: 10.1016/j.monrhu.2021.10.002

Simon Jamard , Tristan Ferry , Florent Valour

{"title":"Physiopathologie des infections ostéoarticulaires","authors":"Simon Jamard , Tristan Ferry , Florent Valour","doi":"10.1016/j.monrhu.2021.10.002","DOIUrl":"10.1016/j.monrhu.2021.10.002","url":null,"abstract":"<div><p>Bone and joint infections gather heterogeneous clinical situation according to the infected site, the presence of orthopedic device and the infection chronicity. Their pathophysiology implicates complex interactions between the infectious agent, host immune system and osteoarticular tissue. It involves virulence factors at the initial phase of tissue invasion and destruction, and persistence mechanisms leading to chronicity and relapse. Infection can arise from three different pathways: direct inoculation during and invasive procedure or an open trauma, extension of a contiguous infection, or hematogenous spread during a bacteremia. Then, bacteria adhesion and the initial development of infection induces an inflammatory response that unbalances bone homeostasis resulting in bone lysis. Conversely, persistence mechanisms allow bacterial escape from the host immune system and the action of most antimicrobials. They include: (i) biofilm formation, a bacterial community adherent to the osteoarticular tissue and/or orthopedic device and organized in a self-produced matrix, that regulates bacterial survival in hostile growth conditions; (ii) bacterial internalization and persistence within bone cells constituting intracellular reservoirs; and (iii) phenotype switching to <em>small colony variants</em> characterized by a reduced metabolism and a tolerance to antimicrobials.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80259356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Apport de l’analyse du liquide synovial au diagnostic des infections articulaires 滑膜液分析对关节感染诊断的贡献

Revue du Rhumatisme Monographies Pub Date : 2022-02-01 DOI: 10.1016/j.monrhu.2021.11.005

Guillaume Coiffier , Olivia Berthoud , Jean-David Albert , Claude Bendavid

{"title":"Apport de l’analyse du liquide synovial au diagnostic des infections articulaires","authors":"Guillaume Coiffier , Olivia Berthoud , Jean-David Albert , Claude Bendavid","doi":"10.1016/j.monrhu.2021.11.005","DOIUrl":"10.1016/j.monrhu.2021.11.005","url":null,"abstract":"<div><p>Synovial fluid analysis is essential for the diagnosis and management of septic arthritis (SA). It allows to identify the pathogen (mainly bacterial) and to study the antibiotics sensitivity (essential for the therapeutic management). Nevertheless, the direct examination is often negative (positive in 15–40% of the cases) and the bacterial culture can be taken in default (positive in 75–85% of the cases) because of an antibiotic therapy set up before the joint puncture, a too small bacterial inoculum or in case of fragile/fastidious bacterial species. Molecular biology techniques (DNAr16S PCR or multiplex PCR) are only of value if positive, and do not seem to increase the sensitivity of bacterial detection during SA. Synovial biomarkers are therefore necessary to allow a diagnosis of SA without bacteriological documentation or to formally eliminate this diagnosis. A synovial white blood cells threshold≥50,000/mm<sup>3</sup> seems insufficient to discriminate SA from another diagnosis (metabolic, crystal-induced or reactive arthritis). Synovial biochemical parameters seem to be of particular interest (lactate, glucose, calprotectin, procalcitonin) while others should be abandoned (protides, LDH). This article reviews the performance of cytological, bacteriological and biochemical parameters of synovial fluid for the diagnosis of SA.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84827765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Échographie des glandes salivaires en rhumatologie 风湿病学中的唾液腺超声

Revue du Rhumatisme Monographies Pub Date : 2021-09-01 DOI: 10.1016/j.monrhu.2021.04.005

Guillaume Le Mélédo , Sandrine Jousse-Joulin

引用次数: 1

Les vertiges cervicaux ont une réalité mais ce ne sont pas de vrais vertiges 颈部眩晕是真实存在的，但它们不是真正的眩晕

Revue du Rhumatisme Monographies Pub Date : 2021-09-01 DOI: 10.1016/j.monrhu.2021.04.004

Jean-Marie Berthelot

{"title":"Les vertiges cervicaux ont une réalité mais ce ne sont pas de vrais vertiges","authors":"Jean-Marie Berthelot","doi":"10.1016/j.monrhu.2021.04.004","DOIUrl":"10.1016/j.monrhu.2021.04.004","url":null,"abstract":"<div><p>Past controversies about the contribution of cervical spine to vertigo mainly resulted from confusion between vertigo and dizziness, and dogmatic belief that spine could not contribute to such conditions. In fact, whereas cervical disorders cannot induce vertigo with nystagmus (which are only explained by ENT or neurological disorders) they can conversely contribute to induce dizziness, through two main mechanisms: (1) impingement of vertebral artery during extremes or brisk cervical rotations (bow-hunter syndrome), especially in patients with loops of vertebral artery or arcuate foramen (ossification of atlo-occiptal ligament on the posterior aspect of axis, making an osseous arch around the vertebral artery). Marked sagittal C1-C2 instability can also reduce flow in vertebral arteries; (2) various abnormal proprioceptive inputs from cervical discs, uncus, zygapophyseal joints, muscles and ligaments or fascias, like the occipito-cervical membrane, can also foster dizziness. Patients with dizziness of putative cervical origin must first be examined by an ENT physician, and neurologist could also be asked to check for alternative explanations before classifying the dizziness as arising partly from the cervical spine and related structures. This possibility should not be denied, moreover as some spine surgery can induce a marked improvement of those dizziness in properly selected patients.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.monrhu.2021.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78814253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Inhibiteurs de la résorption osseuse et risque d’ostéonécrose des mâchoires (ONM) 骨吸收抑制剂和颌骨坏死(ONM)风险

Revue du Rhumatisme Monographies Pub Date : 2021-09-01 DOI: 10.1016/j.monrhu.2021.07.001

Benjamin Salmon , Nathan Moreau , Thomas Funck-Brentano

引用次数: 0

Céphalées de tension 紧张性头痛

Revue du Rhumatisme Monographies Pub Date : 2021-09-01 DOI: 10.1016/j.monrhu.2021.03.008

Caroline Roos

引用次数: 0

Anatomie et imagerie de l’articulation temporo-mandibulaire 颞下颌关节的解剖和成像

Revue du Rhumatisme Monographies Pub Date : 2021-09-01 DOI: 10.1016/j.monrhu.2021.05.002

Christian Vacher , Françoise Cyna Gorse , Lara Nokovitch

{"title":"Anatomie et imagerie de l’articulation temporo-mandibulaire","authors":"Christian Vacher , Françoise Cyna Gorse , Lara Nokovitch","doi":"10.1016/j.monrhu.2021.05.002","DOIUrl":"10.1016/j.monrhu.2021.05.002","url":null,"abstract":"<div><p>Temporomandibular joint (TMJ) is a bicondylar synovial joint containing an articular disc between the carnial basis and the mandible. The osseous conditions of this joint constituted by two condyles makes it very unstable. Stability of these two convex articular surfaces (temporal and mandibular), is constituted by the articular disc, which is a biconcave lens, with a thin center and a thick peripheric labrum, made of fibrocartilage. The capsule-ligamental system participates to the TMJ stability. Among TMJ motor muscles, some of them are elevators and diductors of the mandible, innervated by the mandibular nerve (masseter, temporal medial and lateral pterygoid muscles) and others are depressors of the mandible (platysma, digastrics, mylohyoïd and geniohyoïd muscles). TMJ can be studied by conventional Xrays as the orthopantomogram, which allows XRays focused on the TMJ with mouth opening and mouth closed positions. A CT-scanner of the TMJ is useful in bony trauma or illness (fracture of the condylar process, tumor, tempormandibular ankylosis, arthrosis…). The gold standard exam for the TMJ is MRI which allows a multiplanar and dynamic study using acquisitions at different degrees of mouth opening.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.monrhu.2021.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84229516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Traitements présents et futurs du syndrome sec au cours du syndrome de Gougerot-Sjögren primitif 原始gougerot - sjogren综合征干燥综合征的当前和未来治疗

Revue du Rhumatisme Monographies Pub Date : 2021-09-01 DOI: 10.1016/j.monrhu.2021.04.002

Gaetane Nocturne , Marjolaine Gosset , Antoine Rousseau

引用次数: 0