Les ostéonécroses aseptiques de la tête fémorale chez l'enfant drépanocytaire

Akakpo-Numado, Gamedzi Komlatsè; Gnassingbe, K; Sakiye, Kodjo Abossisso; Boume, Missoki Azanlédji; Amadou, Abdoulatif; Tékou, H

doi:10.1684/san.2008.0126

Cited by 4 publications

(10 citation statements)

References 8 publications

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“…The AVON is rare in the first decade of life; the mean age of its onset was 35 years 31 . In fact, we found in our study 10 , a mean age of 14 years with extremes from 13 to 15 years. In a study by Balogun et al 16 , on 15 patients less than 20 years old, only 2 were aged less than 10 years.…”

Section: Arthritismentioning

confidence: 41%

“…AVON in patients who had co-inherited alpha-thalassaemia trait (17% versus 34%). Phenotypes SS and SC are mainly affected: in our study of 14 cases, there were 8 SS and 6 SC 10 . Femoral head is the most common site 5,32 .…”

Section: Arthritismentioning

confidence: 46%

“…For Milner et al 33 , more than 50% of patients had bilateral hip AVON ( Figure 16). In our study 10 , all the 14 patients had unilateral AVON of the femoral head ( Figure 15). Eight were diagnosed at Ficat's grade 3, and six at Ficat's grade 4.…”

Section: Arthritismentioning

confidence: 57%

“…For 10 years, we have never seen in our service, the AVON of the knee or other joints in children with SCD. The AVON of the hip was only admitted, with annual frequency of 0.7 10 . In the study by Balogun et al 16 , all the 28 AVON affected the femoral head.…”

Section: Arthritismentioning

confidence: 99%

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Osteoarticular complications of sickle cell disease in children

Akakpo-Numado¹,

Boume²,

Mihluedo-Agbolan³

et al. 2013

Hard Tissue

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Introduction Sickle cell disease is the most common molecular disease. The sickling of the haemoglobin S followed by micro-vascular occlusion leads to complications observable in several tissues. Osteoarticular complications represent the most frequent pattern of hospitalization of children with sickle cell disease. This review discusses osteoarticular complications of sickle cell disease in children. Materials and methods This study is a review concerning children <15 years of age. Phenotypes retained are SS, SC and AS, with or without thalassaemia or foetal haemoglobin. Osteomyelitis, arthritis and osteonecrosis are included. Ficat's classification was used for osteonecrosis of femoral head. Discussion Osteomyelitis is the most frequent complication. It is classically due mainly to salmonella species, but currently, several studies have found other microorganisms (Staphylococcus aureus, Streptococcus pneumonia, klebsiella). Multiple sites are affected at the same time. Long bones are the most affected and according to studies, the most frequent are the humerus, the tibia or the femur. Delay to diagnosis often leads to chronic osteomyelitis, with a high risk of orthopaedic sequela. Arthritis can affect all joints. Also due to salmonella and S. aureus, they can have multiple locations. The hip and knee are the favoured sites. Inadequate treatment can result in the destruction of the joints. Avascular osteonecrosis occurs later, after the age of 10. Their evolution is progressive and insidious, explaining the late diagnosis. Osteonecrosis of the femoral head is the most frequent, and poses the problem of hip arthroplasty in children. Conclusion The osteoarticular complications must be hunted in children with sickle cell disease in order to diagnose them early. A quick and efficient treatment enables to avoid serious orthopaedic sequela.

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Section: Arthritismentioning

confidence: 41%

Section: Arthritismentioning

confidence: 46%

Section: Arthritismentioning

confidence: 57%

Section: Arthritismentioning

confidence: 99%

See 2 more Smart Citations

Osteoarticular complications of sickle cell disease in children

Akakpo-Numado¹,

Boume²,

Mihluedo-Agbolan³

et al. 2013

Hard Tissue

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“…Les autres étiologies étaient le cancer et la pathologie post traumatique. La pathologie drépanocytaire vient en première position dans le diagnostic étiologie de l'OATF en Afrique si bien que la plupart des études se sont intéressées à décrire l'OATF chez le drépanocytaire[1,2,3,4]. Ainsi dans la série de DIOP et al au Sénégal, l'OATF est retrouvée chez 9,1% d'une cohorte de 108 drépanocytaires âgés de 20 à 51 ans[2].…”

unclassified

Scintigraphie osseuse trois temps dans la caractérisation de l’ostéonécrose aseptique de la tête fémorale.

KI Thierry Romuald,

DJIGO Salif,

SOUGUE Charles

et al. 2024

J Afr Imag Méd

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Objectifs Décrire les caractéristiques scintigraphiques de l’ostéonécrose avasculaire de la tête fémorale ; Préciser la place des différentes modalités d’imagerie dans le diagnostic de l’ostéonécrose avasculaire de la tête fémorale (ONATF). Matériels et Méthode Au total, nous avons colligé rétrospectivement 12 scintigraphies osseuses positives (SO+) à l’ONATF. Ces SO+ ont été réalisées au Service de Médecine Nucléaire du CHU YO de 2016 à 2021. Un formulaire de recueil de données a été confectionné. Il a permis de collecter les données générales et les résultats de la scintigraphie osseuse. L’étude descriptive consistait à calculer les fréquences pour les variables qualitatives et les moyennes pour les variables quantitatives. La SO en trois temps a été faite chez tous les patients après injection de 296 à 925 MBq d’un dérivé diphosphonate : l’hydroxy méthyléne diphosphonate (HMDP) marqué au technétium 99 m (Tc99m). Résultats 12 patients ont été positifs (SO+) à la recherche scintigraphique de l’ONATF de 2016 à 2021. Leur âge moyen est de 35 ± 14,18 ans avec une nette prédominance féminine (75%). La principale étiologie de l’ONATF reste la drépanocytose. La douleur coxale avec ou sans boiterie a indiqué la réalisation de la SO dans 41,66 % des cas. Les cinq patients (41,6%) qui avaient bénéficié d’une TDM de la hanche concernée ont été adressés pour confirmation du diagnostic (n=1), bilan pré opératoire (n=2), recherche d’autres foyers (n=3). Pour les deux patients atteints de pathologie cancéreuse, le diagnostic d’ONATF était fortuit au décours d’une SO réalisée dans le cadre de leur bilan d’extension. Sur les images scintigraphiques tardives, les atteintes de type II de GOLLSHALK étaient majoritaires, suivis des atteintes de type III puis de type I. Il n’y avait pas d’atteinte de type IV. Les atteintes les plus fréquemment associées sont la poly arthropathie dégénérative. Conclusion La SO est sensible dans la détection de l’ONATF avant l’apparition de la symptomatologie clinique et de la traduction radiologique. Lorsque l’IRM est disponible et n’est pas contre indiquée, la SO est la modalité diagnostique à utiliser en deuxième intention.

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Aseptic Osteonecrosis of the Femoral Head in Children Living with Sickle Cell Disease at the National Reference Center for Sickle Cell Disease of Brazzaville, Congo

FO,

ASW,

et al. 2023

J Blood Disord Med

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Introduction: Aseptic Osteonecrosis of the Femoral Head (AOFH) is a degenerative complication of sickle cell disease. In the absence of care, it is a source of disability through painful lameness and functional impotence that it causes over time. Its data in african children are scarce. This work aimed at determining its prevalence and describing its characteristics. Methodology: It was about a descriptive study conducted over a4 years- period at the CNRDr on children suffering from homozygous sickle cell disease and presenting with ONFH. The studied variables were epidemiological, clinical and paraclinical, collected from medical records. The Postel Merle-d’Aubigné functional score was used to assess the functional status of the hips and the Arlet and Ficat classification for radiological staging. Results: The study involved 31 children (18 boys and 13 girls). The prevalence of AOFH was 2.15%. The average age was 11.51 ± 2.17 years old. Almost half were under 11 (45.16%). At diagnosis, the damage was bilateral in 10/31 cases, bringing the number of pathological hips to 41/62. Hip pain was constant and associated with lameness in 83.87% of cases. Hip function was good, fair, and poor respectively in 41.94%, 54.84% and 3.22% of cases. One child presented with two stiff hips. Radiologically, stages I and II on one hand and III and IV on the other hand of Arlet and Ficat were respectively found in 45.16% and 54.84% of cases. Conclusion: We report one of the most important series of black Africa. AOFH affects young children. The diagnosis is frequently late, made at the stage of functional impotence with joint destruction. The search for predictive factors is important to improve the prognosis of these young patients.

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Les ostéonécroses aseptiques de la tête fémorale chez l'enfant drépanocytaire

Cited by 4 publications

References 8 publications

Osteoarticular complications of sickle cell disease in children

Osteoarticular complications of sickle cell disease in children

Scintigraphie osseuse trois temps dans la caractérisation de l’ostéonécrose aseptique de la tête fémorale.

Aseptic Osteonecrosis of the Femoral Head in Children Living with Sickle Cell Disease at the National Reference Center for Sickle Cell Disease of Brazzaville, Congo

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