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Biomedical subjects

B Maldague

Publications and source records attributed to B Maldague.

At least 73 records · Page 4Linked to original sources
PubMed1987

Radiological manifestations of bisphosphonate treatment with APD in a child suffering from osteogenesis imperfecta.

A 12-year-old female suffering from osteogenesis imperfecta (OI) was treated with 3-amino-1-hydroxypropylidene-1,1-bisphosphonate (APD) orally, 250 mg daily, for periods of 2 months, alternating with periods of 2 months of abstinence. Total duration of therapy was 1 year. Radiological and clinical improvement was striking. Furthermore, X-rays of the bones showed large, parallel radio-opaque striae, corresponding exactly to the periods of therapy. These were present in all metaphyses.

Child↗
PubMed1987

Dynamic radiologic patterns of Paget's disease of bone.

Within the diaphyseal cortex, the primary resorption phase of Paget's disease is often limited either to the endosteum or to the central layers of the cortex. This results in primary resorption fronts that are usually discrete, both radiologically and scintigraphically. The subsequent activation of the subperiosteal cortex may be delayed, leading to secondary expanding fronts associated with subperiosteal new bone formation. Sequential radiographs of 19 untreated patients followed 6.4 +/- 1.2 years showed that the mean extension rate of the lesions within cortical bone was 8 +/- 0.5 mm/year per advancing front. This extension rate showed no significant change in 15 patients treated with calcitonin (CT) and/or ethane-1-hydroxy-1,1-diphosphonate (EHDP), but was significantly decreased in 14 patients treated with 3-amino-1-hydroxypropilidene-1,1-diphosphonate (APD). The increased remodeling rate of pagetic bone magnifies the radiologic changes due to mechanical, dystrophic, and metabolic interferences. Thus, a sclerotic pattern of the disease may rapidly change into a mixed or even a lytic pattern under the influence of any rarefying factor. Conversely, lytic pagetic bone may transform into dense bone through the administration of antiosteoclastic medications such as CT and APD. The reconstructive action of any new therapeutic regimen should be monitored radiologically.

Biomechanical Phenomena↗
PubMed1987

[Septic arthritis of a posterior vertebral inter-apaphysial articulation. Apropos of a case].

A report of a case of haematogenous infection of a lumbar zygapophysial joint. In spite of radiographic and bone scan findings that localised the lesion, the diagnosis was not made until an operative exploration was made, which also effected a cure. This is an unusual site for sepsis and the clinical picture can easily lead to confusion with spondylosis which is much more common.

Arthritis, Infectious↗
PubMed1986

Reflex sympathetic dystrophy syndrome: an unusual mode of presentation of osteomalacia.

We report 2 patients with reflex sympathetic dystrophy syndrome (RSDS) associated with renal tubular osteomalacia. In both patients, RSDS was the presenting manifestation. Treatment of the underlying condition with calcitriol resulted in healing in both patients. These cases prompted us to undertake a retrospective study of 24 consecutive patients with osteomalacia (6 of renal tubular origin, 18 related to vitamin D deficiency), and of 259 consecutive patients with RSDS. Among those with osteomalacia, radiologic lesions strongly suggestive of RSDS were found in 5 patients (21%), 4 of whom had renal tubular defects, and only 1 had vitamin D deficiency. In the group with RSDS, 1 patient (0.4%) was found to have osteomalacia of renal tubular origin. Thus, radiologic findings suggestive of RSDS are frequent in patients with osteomalacia, especially that of renal tubular origin. On rare occasions, the full-blown clinical picture of RSDS may obscure the diagnosis of osteomalacia.

Aged↗
PubMed1986

Transient fatty cortical defects following fractures in children.

Self-regressing subperiosteal defects appearing during consolidation of fractures were observed in two children aged 6 and 10 years, in the tibia and the radius respectively. These transient defects appeared several weeks after fracture, at a distance from the fracture site. They involved the newly formed subperiosteal bone, did not enlarge, and were replaced progressively by normal-appearing bone. A computed tomography (CT) study performed on one of these defects demonstrated a density consistent with a fatty content. It is suggested that these transient post-traumatic defects could result from the inclusion of medullary fat drops within the subperiosteal hematoma near the fracture site.

Bone Cysts↗
PubMed1986

Sciatic neuropathy at the popliteal fossa: clinical, ultrasonographic and computed tomographic diagnosis.

A 22-year-old female had been suffering from sciatica-like pain in the left leg for four years. Clinical findings strongly directed further investigations to the popliteal fossa. Ultrasonography located a hypoechogenic mass in the upper lateral popliteal space. Guided by these data, computerized tomography (CT) with vertical reconstructions made the tentative diagnosis of a common peroneal nerve tumor, which was confirmed at operation. Microscopic examination showed a neurinoma of the mixed neurilemmoma-neurofibroma type. In the presence of atypical features of sciatica, a high index of suspicion seems advisable. Emphasis is laid on the complementary contribution of ultrasonography and CT in this type of ill-defined lower limb pain.

Adult↗
PubMed1986

Cutaneous mucinosis associated with multiple frozen joints and bony heterotopic deposits around the hips.

A 43-year-old man suffered from migrating then additive arthralgias associated with macroscopic and microscopic cutaneous lesions compatible at first sight with reticular erythematous mucinosis. After nine months, the cutaneous picture evolved into a papular mucinosis. The patient developed "multiple frozen joints" with heterotopic bony deposits around the hips. To our knowledge, such articular problems have not yet been described in this condition. Severe systemic complications prompted the authors to treat the patient with plasma exchange and melphalan.

Adult↗
PubMed1986

Intra-articular calcification in progressive systemic sclerosis.

Subcutaneous and periarticular dystrophic calcifications are well known to be associated with progressive systemic sclerosis (PSS). On the other hand, calcifications inside the joints are very rarely reported. We report a new case of this unusual complication of PSS. The observation of the complete radiological follow-up led us to propose a mechanical rather than a purely inflammatory pathogenetic mechanism of this complication.

Biopsy↗
PubMed1986

The arthritis of hemochromatosis. A review of 25 cases with special reference to chondrocalcinosis, and a comparison with patients with primary hyperparathyroidism and controls.

Twenty-five cases of hemochromatosis established on histological grounds were reviewed in order to study their articular complaints. Symptoms relating to articular damage were the first signs of the disease in about one quarter of the cases. More than half of the patients (n = 14) exhibited inflammatory arthritis, usually of the hands and knees. The arthritis was chronic in all the patients. Acute arthritis of the joints of the hands and feet appeared in the course of the disease in two patients. Chondrocalcinosis was present in 20% of cases with X-rays of joints (n = 20). The classical subchondral arthropathy was observed in the metacarpophalangeal joints in 35% of the patients. In two patients chondrocalcinosis and subchondral arthropathy were both present. These data are compared with those of 66 patients suffering from primary hyperparathyroidism and of 229 controls with rheumatic complaints. The severity of the arthropathy in hemochromatosis is stressed.

Adult↗