Beck disease have been studied in Central Tibet. Statistical analysis of physical signs allowed a definition of the clinical diagnosis and a scale for the functional severity for the disease to be drawn up. This classification is used for the assessment of patients who received palliative physical treatment. A group of 136 patients have been examined and their disabled joints classified according to pain, bony enlargement and restriction of movement. 57% were between 20 and 35 years of age. The patients mainly complained about their distal weightbearing joints. The clinical evolution of the disease is described from childhood to adult life. Résumé. Les signes cliniques de la maladie de Kashin-Beck (KBD) sont étudiés dans le Tibet central. L'analyse statistique des symptômes a permis aux auteurs de mieux définir le diagnostic clinique évoqué dans la littérature et de proposer une classification fonctionnelle de l'évolution de la maladie. Cette classification sera utilisée ultérieurement pour l'évaluation des patients KBD qui recevront un traitement de kinésithérapie. La distribution des cas est étudiée en fonction de l'âge, du sexe et de la gravité. Les articulations atteintes sont classées en fonction des principales manifestations cliniques: la douleur, l'élargissement des articulations et la limitation de l'amplitude articulaire. Cinquante-sept pour cent des cas étudiés sont de jeunes adultes (20 à 35 ans). Les symptô-mes principaux sont très constants. Les plaintes dominantes des patients ont pour origines les articulations distales des membres inférieurs. L'évolution clinique est décrite depuis l'enfance jusqu'à l'âge adulte.
The results of this study do not rule out the possibility that selenium may help to prevent the occurrence of Kashin-Beck disease. However, selenium supplementation had no effect on established Kashin-Beck disease, growth, or thyroid function once iodine deficiency was corrected. These results suggest that iodine, but not selenium, deficiency should be corrected in Tibetan children with Kashin-Beck disease.
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