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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The objective of treatment of necrosis of the femoral head by means of an appropriate cup is to protect the sequestrum and to avoid secondary arthrosis. Hemispherical cups have a tendency to be easily deformed; cups with cylindrical support should be used in preference as they are mechanically stable and make it possible to cover the femoral head in cases of relatively extensive necrosis. Good results are obtained quickly and are often spectacular : in 90 percent of the cases operated on, pain disappeared or was reduced and normal socio-professional activity was again possible. A clinical and radiological study of 30 hips treated at least 2 years previously, established that the result was stable in the majority of cases : there was one real clinical and radiological deterioration, two cases of pinching of the interspace. This operation is thus worth while in all cases of necrosis, at the stage when the sequestrum is clearly delimited and when there is clear deformation of the contour of the femoral head. It also seems to be worth while at the "eggshell" stage, when the lesions detected at the time of an operation are aften considerable and appear non-reversible : the quality of the results obtained mean that the criteria of tolerance should be much more severe.
Rev Rhum Mal Osteoartic 1975 Apr
PMID:[Treatment of idiopathic femur head necrosis with an appropriate cup with cylindrical support]. 114 83

Coxopathies with rapid chondrolysis: Comparison of clinical and anatomical findings. Clinical, radiological, laboratory, and antomical data concerning 14 coxopathies with rapid chodrolysis are presented with reference to 12 patients aged from 37 to 77 years. Three criteria define this affection: reduction of the joint space by at least 50 per cent, in one year or less; chondrolysis completed in 1 to 3 years; complete narrowing in the superior part of the joint; isolated narrowing, exceptionally with a discrete osteophytosis. The pain rapidly becomes very severe. Such symptoms are, at first, indicative of coxitis, but the establishment of a radio-clinical picture of coxopathy rapid chrondrolysis is more indicative of an arthrosic origin. This could represent a particular evolutive stage of coxarthrosis related to the initial chondrolytic phase of rapid destructive coxarthrosis. From an early stage, the anatomical facts indicate an association between the degenerative lesions and the non-specific inflammatory lesions of the synovial membrane. These facts are interpreted, on the basis of data in the literature, as an indication of synovial lesions caused by the liberation of osteocartilaginous fragments. The problem of the pathogenesis of this rapid chondrolysis is then discussed.
Rev Rhum Mal Osteoartic 1975 May
PMID:Hip diseases with rapid chondrolysis. Clinical and anatomical comparison. 114 87

The authors compared the different elements of diagnosis contributed by the clinical examination, and by laboratory and radiological investigations in 33 cases of Pott's disease and 46 cases of non-tuberculous spondylodiscitis. They show that certain elements indicate the diagnosis of Pott's disease : associated visceral tuberculosis, and a radiogram showing in particular a centro-somatic notch, recent primary infection, absence of pain, minimum signs of medullary compression ; other elements on the other hand, indicate a diagnosis of non-tuberculous spondylodiscitis : a negative cutaneous tuberculin test, a positive haemoculture, humoral signs of melitococcosis or of typhoid fever, any indication of possible means of entry of infection in the two months before the disease, radiological signs of reconstruction in the first four months of evolution, location of the lesion in the anterior upper part of the vertebra, and to a lesser degree, the acute febrile nature of the clinical picture. The authors recall that the existence of a large abscess, of which there were no examples in the present series, is an indication in favour of tuberculosis.
Rev Rhum Mal Osteoartic 1975 Mar
PMID:[Etiological diagnosis of spondylitis. I. Clinical, biological and radiological aspects]. 117 22

The authors report their experiences of the surgical treatment of external femoro-patellar arthrosis with displacement of the kneecap, by recentering the kneecap, on knees that were not deformed as seen from the front. This recentering of the kneecap, which was monitored during the operation by radiographs with axial projection, was obtained by internal transposition of anterior tibial tuberosity and section of the external " wing " of the patella. No inert or living material was placed between the patella and the trochlea. The reduction in pain and the improvement in articular function depend on how well the patella is recentered. Twenty-two cases of external femoro-patellar arthrosis with displacement of the kneecap were treated in this way; in 18 operations, 14 results that remained favourable for more than 6 months have encouraged the authors to continue their trials and to abandon, at least for the time being, patellectomies and patelloplasties.
Rev Rhum Mal Osteoartic 1975 Mar
PMID:[Recentering the patella in the treatment of external femoropatellar arthrosis with displacement of the patella]. 117 23

The authors report 12 cases of Paget's disease with sarcomatous degeneration that were observed among 311 patients with Paget's disease hospitalized in the Montpellier Rheumatology Clinic. They compare their experience with information they were able to extract from the literature in French and English. The frequency of such degeneration in cases of Paget's disease is difficult to determine but did not appear to exceed 1%. Degeneration rarely occurred before the age of 50 years, affected men twice as frequently as women, and occurred particularly in cases of diffuse Paget's disease, mainly in the femur or the humerus; the rachis was rarely affected. Pain was the main symptom, was practically constant, was remarkable because of its permanence and its intensity. Tumefaction was frequently seen. Pathological fractures were seen in almost a third of the patients with sarcomas of the long bones. Radiculo-medullary compression characterized the rare cases with involvement of the vertebral column or the sacrum. Radiography showed rupture of cortical layers with invasion of the soft parts without any periostal reaction. Histological investigation confirmed the diagnosis by demonstrating one of the three types of osteogenic sarcoma: osteosarcomas were the most frequent. Less frequently giant-cell sarcomas or reticulosarcomas were found. The affected patients nearly always died, survival at five years being rare. Treatment, amputation or radiotherapy, was disappointing.
Rev Rhum Mal Osteoartic 1975 Nov
PMID:[Sarcomas associated with Paget's disease]. 122 55

Paget's disease of the bones of the feet is not unusual. Twenty patients out of every hundred present the signs of Paget's disease in the foot bones. The calcaneus is the bone most often affected (18 cases) but the cuboid, the metatarsals, and the astragalus (often as well as the calcaneus) may also be affected. Paget's disease of the foot remains latent clinically: 2 patients complained of talalgia; a third had a deformation of the rear part of the foot which made it difficult to wear a shoe. Pagetic deformations of the lower limb affect the foot but without pain. They are often compensated for by putting more weight on the fore-foot in cases of shortening of the lower limb or on the external arch in cases of bowed deformation of the lower limb.
Rev Rhum Mal Osteoartic 1976 Jan
PMID:[Foot involvement in Paget's disease of bone]. 125 84

Can a contusion cause coxarthrosis in the absence of both fracture and dislocation? Yes. To demonstrate this the authors report 6 cases that fulfil the following conditions: (1) Simple but violent contusion affecting the greater trochanter or the knee (dashboard accident) or a forced movement, such as in doing the splits; (2) immediate or slightly delayed pain, generally of short duration (a few weeks); (3) absence of coxarthrogenic malformations and absence of pre-existing signs of a pathological hip condition; (4) progressive coxarthrosis on the side of the contusion; (5) chronological relation between the development of the coxarthrosis images and the date of the contusion; (6) subjects less than 35 years of age, in order to eliminate cases with latent primary pre-coxarthrosis. The average age of the six patients at the start of the coxarthrosis was 24.7 years (range: 13 to 33 years); there were four men and two women. In five of the six cases a violent contusion in the trochanter region was involved as a result of a fall on a hard surface or a traffic accident. In one case a forced movement on landing from a jump was involved. Evolution in three periods is usual: the hip is painful either immediately or after a few weeks (particularly on rising after a period in bed for multiple injuries). This post-traumatic pain lasts from ten days to one month, rarely longer. It is followed by a period free of pain that may last from five months to ten years (average: five years). Subsequently there is pain every day and the onset of the limp associated with coxarthrosis. Radiographically the reduction of the joint space and/or the osteophytosis appears after three months to two years (average: one year). However, there may not be any pain associated with these lesions for a long time. The authors propose that the first five conditions enumerated above represent the essential medico-legal conditions of coxarthrosis by contusion. The restriction as regards age (No 6) was introduced only to show clearly the existence of post-contusive coxarthrosis. However, even if one or more of the medico-legal conditions are not fulfilled the imputability may still be valid. Some such cases are discussed.
Rev Rhum Mal Osteoartic 1976 Jan
PMID:[Coxarthrosis due to contusion]. 125 86

On the basis of well defined diagnostic criteria, the authors conclude that periodic disease affects males in particular. It commences before the age of 20 years in 80 percent of cases. In particular it occurs in Armenian and Shiite communities. Its evolution is normally benign ; amyloidosis is found in only 8 percent of cases. Joint manifestations are found in 48 percent of cases and may take on different aspects and occur in several different sites : myaglia or arthralgia, monoarthitis, oligoarthritis, polyarthritis, neck or sacroiliac pain. The authors have not noted prolonged peripheral joint episodes. No cases of amyloidosis were diagnosed before the appearance of the clinical signs of the disease. An autosomal, dominant heredity with incomplete penetration seems to be the most likely hypothesis.
Rev Rhum Mal Osteoartic 1976 Apr
PMID:[Periodic disease (familial paroxysmal polyseritis). 52 cases]. 127 76

With reference to a series of thirty synovectomies of the wrist in patients with rheumatoid arthritis, the authors report the results observed after an average interval of three years and six months. There was a remarkable reduction in pain in three-quarters of the cases. On the other hand, loss of mobility was noted in 15 patients. Resection of the cubital head was carried out in half of the cases. This was followed in two cases by internal translocation of the carpus, and in three cases by internal translocation combined with cubital inclination of the hand. The results of the tenddon repairs carried out in six patients have been completely satisfactory. A study of the present cases and of data from the literature confirms the local prophylactic value of tenosynovectomy which may also prevent tendon ruptures. The best result are seen in the less evolutive forms in which the risk of relapse is least, and in cases in which surgery is carried out on stable wrists with cartilage showing little alteration. In the presence of inferior radiocubital arthritis the resection must be systematic as it makes it possible to carry out a complete synovectomy of this joint. The authors compare the value of surgical synovectomy of the wrist with that of radioactive synoviorthesis.
Rev Rhum Mal Osteoartic 1976 Apr
PMID:[Dorsal tenosynovectomy of the wrist in rheumatoid arthritis. Results obtained in 30 cases]. 127 78

Fifty patients (38 men) with unstable angina pectoris defined by: pain lasting > 15 minutes+percritical electrocardiographic changes+significant coronary narrowing on coronary angiography (Coro 1) performed within 24 hours, were treated in a double blind protocol with rt-PA (n = 25) 100 mg/90 minutes (10 mg bolus + 90 mg/90 minutes or placebo (n = 25). All received effective intravenous heparin and intravenous nitrates. Calcium antagonists and betablockers were prescribed in half the cases. Aspirin (100 mg orally per day) was prescribed after control coronary angiography (Coro 2) performed 24 +/- 6 hours after starting treatment. Qualitative and quantitative analysis (CAESAR system) was centralised. There were no differences in the angiographic findings between the two groups. Intracoronary thrombosis was observed in 43% (rt-PA) and 44% (placebo) in Coro 1 and in 17% and 28% in Coro 2. The incidence of myocardial revascularisation procedures was similar in the two groups: angioplasty: 12 (rt-PA) and 13 (placebo); coronary bypass surgery: 5 (rt-PA) and 6 (placebo). Seven patients developed myocardial infarction (5 rt-PA, 2 placebo), one of whom died of cardiogenic shock (placebo). Eighteen patients had haemorrhagic complications (14 rt-PA, 4 placebo; p < 0.002) mainly at the puncture sites (12/14, 3/4). Spontaneous haemorrhage occurred in 7/25 (28%) of patients on rt-PA (haematuria 3, gastrointestinal haemorrhage 2, haematuria + gastrointestinal haemorrhage 1, epistaxis 1) and in 1/25 patients on placebo (gastrointestinal haemorrhage) This study shows that intravenous thrombolysis with rt-PA in severe unstable angina pectoris doe not modify the clinical outcome or the angiographic lesions but exposes patients to a high risk of haemorrhagic complications.
Arch Mal Coeur Vaiss 1992 Oct
PMID:[Intravenous thrombolysis by recombinant plasminogen activator (rt-PA) in unstable angina. A randomized multicenter study versus placebo]. 129 97


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