Aim: Determine the frequency and respective proportion of the various etiological forms of arthritis in Lomé (Togo). Patients and Methods: Transversal study carried out over 15 years on files of arthritis infected patients and submitted to rheumatologic consultation. Results: 1081 out of 13,517 patients examined (8%) were suffering from arthritis. Those 1081 patients (456 women, 42.2% and 625 men, 57.8%) were in average 38 years old and enjoyed an average duration of evolution of three years. The chronic inflammatory rheumatisms (CIR) (602 cases, 56.9%), the metabolic arthropathies (233 cases, 22%) and the infections (198 cases, 16.6%), were the main etiologies that were observed. The average age of 198 patients with infectious arthritis was 36 years and the average duration of 9 months. Infectious arthritis was preferably located at the knee (34.3%), and was essentially caused by a banal germ (157 patients; 79.3%) and associated with HIV in 25 patients (15.9%). The remaining 233 patients (9 women, and 224 men) suffering from metabolic arthritis were in average 52 years old and enjoyed an average duration of evolution of five years. The chronic inflammatory rheumatisms were mainly represented by spondyloarthropathies (90 cases, 14.9%) and the arthritis rheumatoid (64 cases, 10.6%). 399 out of 602 cases of the CIR were not classified while 52 cases were associated with HIV. The connective tissue diseases were dominated by the polymyositis (9 cases, 18.7%). Conclusion: The chronic inflammatory rheumatisms were the first causal form of arthritis in rheumatologic consultation in Lomé.

Background: Tuberculosis (TB) bacteria can infect any bone, joint, tendon, or bursa; however, the most common musculoskeletal site for infection includes the spine and weight-bearing joints of the hip and knee. A tubercular involvement of the wrist is rare.Aim of the work: To describe a rare case of tuberculosis of wrist.Case report: A 37-year-old man with a history of immunosuppressed Human Immunodeficiency Virus (HIV) infection was referred to the Rheumatology department for a 10 month history of lowgrade fever, swelling and pain in the wrist. X-ray and wrist CT scan, revealed an osteolytic lesion of the wrist. Cold abscess aspiration cytology was negative for acid-fast bacilli but the Polymerase Chain Reaction, using Xpert MTB/RIF (Mycobacterium tuberculosis/resistance to rifampicin) diagnostic test done on the cold abscess fluid was positive in revealing Mycobacterium tuberculosis. The evolution under specific antibiotic treatment has been favorable, with the disappearance of wrist pain and a regression of swelling.Conclusion: This case highlights that TB should be taken into consideration when dealing with nonspecific chronic wrist arthritis, especially if the patient is immunocompromised HIV infected.

Objective: To determine the prevalence and factors associated with neuropathic pain in patients with non-specific low back pain. Methods: This was a cross-sectional study conducted from May to July 2016 in the Rheumatology, Neurology and Neurosurgery departments of Lome. The DN4 questionnaire was used for the diagnosis of neuropathic pain in the 200 patients with low back pain included in this study. Results: Of the 200 patients (147 women and 53 men) included in the study, neuropathic pain European Scientific Journal August 2017 edition Vol.13, No.24 ISSN: 1857 -7881 (Print) e -ISSN 1857 268 was present in 92 (46%). The average age of the 92 patients (67 women vs 25 men, p = 0.04) was 55.5 ± 12.4 years (women 55.2 ± 12.8 vs. men 54.6 ± 11.4, p = 0.5). The characteristics of neuropathic pain mainly found were: burning sensation (n = 67, 72.8%); electrical discharges (n = 64, 69.6%); tingling (n = 90; 97.8%); tickling (n = 57; 62%); numbness (n = 89; 96.7%); hypoesthesia (n = 52; 56.5%). Factors significantly associated with the presence of neuropathic pain in LBP were age (p = 0.005), duration of LBP (p = 0.04), high blood pressure (p = 0.001), radicular pain (p = 0.00002) and the past history of the LBP (0.000000). Conclusion: Neuropathic pain is common in patients with LBP at Lome. The duration of LBP, past history of LBP, previous NSAID use, BMI, pain severity and radicular pain appear to be predictive of the occurrence of these neuropathic pains. Hommes 54,6± 11,4 ; p = 0.5). Les items de la DN retrouvés étaient essentiellement : brûlures (n=67 ; 72,8%) ; décharges électriques (n=64 ; 69,6%) ; fourmillements (n=90 ; 97,8%) ; picotements (n=57 ; 62%) ; engourdissement (n=89 ; 96,7%) ; hypoesthésie (n=52 ; 56,5%). Les facteurs significativement associés à l'existence de DN au cours des LC étaient dominés par l'âge (p = 0,005), la durée d'évolution de la lombalgie (p= 0,04), l'HTA (p = 0,001), les radiculalgies (p = 0,00002) et l'antécédent de lomboradiculalgie (0,000000). Conclusion : La DN est fréquente chez des patients souffrant de LC à Lomé.L'âge, la durée d'évolution de la lombalgie, l'antécédent de lomboradiculalgie, la prise antérieure d'AINS, l'IMC, l'intensité de la douleur et les radiculalgies semblent prédictives de la survenue de ces DN.

Objectives: To determine the epidemiological, clinical and paraclinical profile of bone metastases cancer. Patients and Methods: It was a retrospective study performed on a series of cases, admitted in Rheumatology department of the University Teaching Hospital of Lomé, Togo from October 1989 to December 2008. The diagnosis of bone metastasis was made because of the existence of inflammatory bone pain, or pathological fracture, or bone swelling and a bone condensing or mixed or osteolytic radiological image. The anatomopathological evidence was made after biopsy of the bone lesion or primary cancer. 2018 patients were hospitalized in rheumatology, and among them 77 had documented bone metastasis. Results: There were 53 men (68.8%) and 24 women (31.2%) with a sex ratio of 2.2. The mean age was 56.6 ± 12.6 years, ranging from 21 to 82 years. The primary cancer most frequently found was that of the prostate, representing 57.1% of bone metastasis and breast in 15.6%. The main manifestations of patients with bone metastases were inflammatory bone pain (76.6%) and alteration of general condition (75.3%). The spine was the main area of pain (64.9%). The metastasis was bone condensing in 48.1% of cases, osteolytic in 40.3% and mixed in 11.6%. The average survival was 22 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 diagnosis of the primary tumor is often made at the stage of metastasis in black Africa.

Chronic non-specific low back pain has an important psychological impact. Objectives: To determine the prevalence of anxiety and depressive disorders (ADD) and factors associated to their apparition in patients suffering from chronic non-specific low back pain in rheumatological consultation in Lomé. Patients and Methods: It was a cross-sectional study, conducted from October 1 st , 2015 to 31 st March 2016. This study focused on all patients suffering from common chronic low back pain without psychiatric history in the Rheumatology Ward at the Sylvanus Olympio's Teaching Hospital of Lomé and who have given their consent. The psychological evaluation was carried out through Hamilton scale. The processing, the statistical treatment and analysis of our data have been carried out using Epiinfo software, version 7.1.5. The investigation was approved by the local Ethics Committee. Results: 48 (39 women and 09 men) out of 123 patients with chronic lower back pain presented anxiety and depressive disorders (ADD) accounting for a prevalence rate of 39%. Their average age was 50.3 years old. The most frequent ADD was: psychic anxiety (58.6%), depressive mood (51.3%), difficulties to feel asleep (47.9%) and disturbed or agitated sleep (43.1%). Factors associated with the anxiety and depressive disorders in common chronic low back pain were: female gender (p = 0.02), dependent children (p = 0.02), occupation (reseller (p = 0.002), liberal profession (p = 0.009), monthly financial income (p = 0.002), surroundings family (0.009), medical history (p = 0.0002) and pain's intensity > 7 (p = 0.04). Conclusion: This study shows the high frequency of anxiety and depressive disorders in common chronic low back pain and their influence by socio-economic and demographic factors.