Objectives: To report an epidemiology study and prognosis for metastatic bone tumor. Methodology: It was a descriptive, transversal study on records of patients hospitalized in Rheumatology and Oncology-Radiotherapy departments of the University Teaching Hospital of Brazzaville, Congo from 1 January 2005 to 31 July 2011 (7 years and 6 months). The diagnosis of bone metastasis was made because of the existence of bone pain, or pathological fracture, or bone swelling and a bone-condensing or mixed or osteolytic radiological image. The anatomo-pathological evidence was made after biopsy of the bone lesion or primary cancer. 3687 patients were hospitalized for active cancer, among them 81 had documented bone metastasis. Results: There were 60 men (74.1%) and 21 women (25.9%) with a sex ratio of 2.85. The average age was 53 years, ranging from 3 to 80 years. 75% of patients were more or equal to 50 years old at the discovery of the bone metastasis. Bone pain was the main mode of discovery (67.9% of cases). However, in 6.2% of cases, it was discovered incidentally. The metastasis was bone condensing in 50.7% of cases, osteolytic in 40.7% and mixed in 8.6%. They were unifocal in 25.9% and multifocal in 74.1% of cases. The Primary cancer most frequently found was that of the prostate in 55.6% of cases, breast in 20.7% and rhabdomyosarcoma in 4.9%. In 6.2% of cases, the primary site of cancer was unknown. The average survival was 25 months. Conclusion: The clinical and radiological presentation remains classic. Cancer of the prostate and breast are the main neoplasia responsible for bone metastasis in our series. The discovery of metastasis remains a major evolutionary step of cancer.
We're reporting the case of an arthritis to banal germ occurred in concomitance with an advanced polyarticular of gout. It was about a patient of 59 years with alcoholic and gouty chronicle more than 10 years, but without specialized medical follow-up. He has been admitted in hospitalization for a big inflammatory and stiff right knee, letting rising the pus through two cutaneous fistulas in a context of non-febrile change of his peripheral polyarthritis of the big and small articulations. Gout was at distal predominance, bilateral, distorting, tophaceous and active. Inflammatory syndrome was important (ESR = 50 mm in the 1st hour and CRP = 28 mg/l) and uricemia was high, at 84 mg/l. The glycaemia, the hepatic, the viral, renal and serological evaluation (HIV and B, C hepatitis) were normal. The bacteriological analysis of the pus collected after puncture of the knee and cleaning identified a negative gram bacillus, Morganella morganii, multi-resistant, but sensitive to the Imipeneme and to the aminosides. The evolution was lethal in a picture of multivisceral failing in spite of a bi-antibiotherapy and under hypo-uricemia treatment prescription.
The authors report a new case of spine tuberculosis of C1-C2 occurred in a 58-year-old negative HIV patient that was responsible of inflammatory cervical pain with multidirectional stiffness and complicated by spastic quadriplegia. The diagnosis was made on the basis of presumptive elements, including cervical spinal CT scan, which showed atlanto-axial subluxation (C1-C2) with destruction of the odontoid apophysis and lateral mass of the atlas and favorable evolution under specific antibiotic treatment with ethambutol, isoniazid, rifampicin, pyrazinamide and immobilization with brace cast, despite the absence of bacteriological and anatomo-pathological evidence of certainty. The evolution has been favorable, with the disappearance of cervical pain, progressive motor recovery and resumption of autonomy of walking.
Objective: To describe the clinical and radiological profile of lumbar spondylolisthesis seen in a hospital setting. Patients and method: A crosssectional survey, on medical records, conducted in the departments of Rheumatology and Neurosurgery of the University Teaching Hospital of
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