[Betamethasone in the prevention of allergic complications caused by intravenous iodine contrast media].
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Biomedical subjects
Publications and source records attributed to A Chevrot.
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The authors report a retrospective study of 121 arthrographies of the hip in adults, excluding prostheses. The study was based on normal pathological values for angular measurement of the labrum acetabular: ECB angle (mean value: 15 degrees) enlarging the lateral cover of the head of the femur, VCE angle (mean value: 30 degrees) and a mean global VCB angle of 45 degrees. A certain equilibrium was observed between the covering capacity of the acetabulum and the covering capacity of the labrum acetabular. Numerous anomalies of the labrum were observed, including fissures in about 30% of cases. A large number of fissures were associated with other degenerative anomalies of the hip joint. A few fissures resulting in detachment of a strip of labrum were isolated and the possibility of their traumatic etiology and their pathogenic nature in clinical symptoms are discussed.
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A method is described for control of a bicipital groove projection using a tele-controlled table with centering guided by direct screen imaging: the patient is placed in contralateral anterior oblique position with the arm in antepulsion to project the groove into the supraspinal fossa on a lateral scapular image.
The authors study the diagnostic accuracy of quasi axial view during discography about 136 discs with proved herniation. It is a good helm to the frontal and lateral views.
The authors describe a new view of the discography comparable to the axial CT imaging of the disc, so they used the name of "quasi-axial" view. They point the landmarks of this new picture.
A case of desmoid fibroma of anterior abdominal wall, an exceptional benign tumor, is reported. Based on results of CT scan imaging of this lesion, differential diagnosis of other expansive processes of abdominal wall are discussed. This benign tumor is a potentially serious lesion due to its infiltrating character and the high incidence of recurrence. The need for total surgical excision is emphasized.
The authors report 8 cases of patients with synovial cysts (3 cases) or diverticuli (5 cases) of the lumbar joints, compressing the sciatic roots. They describe the radiological aspects of the two sides of the degenerative pathology of the posterior articular processes, which are relatively unrecognized (14 cases in the literature). They insist on the advantage of saccoradiculography which is the only test to be able to demonstrate dynamic alterations in relation with diverticuli, if performed in a standing position. The authors show the advantage of tomodensitometry which supports the diagnosis of cyst in the presence of a fibrous wall image. They emphasize the value of the arthrography of the posterior joint; it presents a diagnostic role by visualizing the cavities, and a therapeutic role by permitting the injection in situ of steroids and/or local anesthetics.
Spontaneous fractures of the sternum are unusual. They can simulate cardio-thoracic emergencies. A case of stress fracture of the sternum and of the femoral neck in a patient with corticosteroid induced osteoporosis is reported and the peculiar value of CT assessing the absence of tumoral mass is emphasized.
A 22-year-old woman with an osteoid osteoma of capitate bone presented initially with arthritis of wrist. Bone scan imaging and digital subtraction angiography allowed diagnosis of a nidus. This case draws attention to articular manifestations of osteoid osteoma.
Fifteen cases of ankylosing spondylarthritis, associated to an IgA nephropathy have been reported in the literature. This association may be fortuitous, or on the contrary suggest a common pathogenic link between the two diseases and the authors have compared the incidence of radiological abnormalities of the sacro-iliac joints as well as the incidence of rheumatoid clinical signs in 186 patients suffering from an IgA nephropathy to those observed in 192 reference patients. This study could not demonstrate any difference between the two groups and, therefore, suggests that the cases reported in the literature are secondary to a simple fortuitous association.
A randomized, double-blind study was made of 39 patients with discolumbar hernias that were unresponsive to medical treatment. They were treated either by nucleolysis with chymopapain (4 000 U of discase), or by discography followed by injection of distilled water as a placebo. After one month, treatment was found to be successful in 55% of cases undergoing nucleolysis and in 26% of cases receiving the placebo. The results after 3 months were 65% and 42%. respectively. After one month, the intensity of lumbar pain decreased by 44% on average in the group treated by chymopapain, and by 0% in the placebo group. Radicular pain decreased by 53% in the first group and by 26% in the placebo group, and improvement in Lasègue's sign was 51% and 20%, respectively. Analgesic treatment was reduced in patients treated by chymopapain: 65% of patients in the first group report some or much improvement in their sciatica, whereas this figure was 26% in the placebo group (p less than 0.02). Contralateral sciatica was observed in 3 patients of the placebo group. The average give in the disc one month after nucleolysis was 34% in the chymopapain group and 27% in the placebo group, without correlation with the clinical result. On average, patients were monitored for one year after nucleolysis, and during this year 6 patients from the chymopapain group were operated upon, compared with 10 patients from the placebo group. Although these results are at the limit of statistical significance because of the number of patients studied, they confirm the innocuousness and effectiveness of chymopapain in the treatment of discolumbar hernias.
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Measurement of anteversion of cotyle of total hip prosthesis generally involves projection of equatorial guide included in cotyloid piece. Direct measurement of cotyloid anteversion on Arcelin's surgical lateral image showed this method to be a simple, reliable, direct procedure for determination of cotyloid anteversion of total hip prosthesis.
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