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Biomedical subjects

G H Fallet

Publications and source records attributed to G H Fallet.

At least 37 records · Page 2Linked to original sources
PubMed1977

[Synoviorthesis of the knee with osmic acid (OsO4). Results at mid-term].

Synoviorthesis of the knee joint with OsO4 is a simple procedure with few short or long term side effects. The substance used is inexpensive and easy to handle. All studies published so far have confirmed its suitability in the treatment of synovitis of the knee and various other joints. The initial good results deteriorate steadily, primarily in the first year following injection. However, intra-articular administration of OsO4 may be repeated without risk, and achieves as good results as the first synoviorthesis. The less advanced the lesions and the less active clinically and biologically the systemic manifestations, the better the results. Osmic acid does not appear to damage the joint either radiologically or functionally. The effect of OsO4, although probably shorter in duration, is comparable to that of yttrium-90, with the additional advantage that it can be used in young patients. 100 mg (5 ml of 2% solution) can be considered the optimal dose. Synoviorthesis with osmic acid can be performed before going on to surgical synovectomy. Synoviorthesis with osmic acid is ineffective in the treatment of gonarthrosis.

Adolescent↗
PubMed1977

Tendon calcifications in chondrocalcinosis. A clinical, radiologic, histologic, and crystallographic study.

Fine linear extraarticular calcium deposits were found in X-rays of 7 of 52 patients with articular chondrocalcinosis (ACC). Seven Achilles tendons, seven quadriceps tendons, and one plantar fascia were affected. In a control group of comparable age and sex, without ACC but with generalized osteoarthritis, no calcifications were found in the tendons. On a biopsy specimen of Achilles tendon with such calcium deposits, X-ray diffraction showed that they had the characteristics of calcium pyrophosphate dilhydrate. Isolated small foci of crystals were observed on some segments of tendon bundles. The presence of fine linear calcifications on X-rays of the Achilles or quadriceps tendons may be a useful aid in the radiologic diagnosis of so-called articular chondrocalcinosis.

Achilles Tendon↗
PubMed1977

The painful heel. Comparative study in rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthrosis.

This study presents the frequency of severe and mild talalgias in unselected, consecutive patients with rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthosis. Achilles tendinitis and plantar fasciitis caused a severe talalgia and they were observed mainly in males with Reiter's syndrome or ankylosing spondylitis. On the other hand, sub-Achilles bursitis more frequently affected women with rheumatoid arthritis and rarely gave rise to severe talalgias. The simple calcaneal spur was associated with generalized osteoarthrosis and its frequency increased with age. This condition was not related to talalgias. Finally, clinical and radiological involvement of the subtalar and midtarsal joints were observed mainly in rheumatoid arthritis and occasionally caused apes valgoplanus.

Adult↗
PubMed1977

Secondary syphilis revealed by rheumatic complaints.

Six patients (five men and one woman) are described, who consulted rheumatologists with varied rheumatic complaints: four had subacute synovitis with effusion, frequently associated with vague arthralgias; and five of the patients had back pain which was more severe at rest. Most of the patients had some clinical signs of secondary syphilis, such as roseola, loss of hair, or lymphadenopathy, and their serological reactions for lues were strongly positive. Since no other cause for these rheumatic complaints could be found, secondary syphilis was considered responsible for them. In all cases the rheumatic complaints cleared with specific treatment.

Adult↗
PubMed1977

Coexistence of rheumatoid arthritis and ankylosing spondylitis--report of 10 cases.

The distinction between rheumatoid arthritis (RA) and ankylosing spondylitis (AS) has hitherto relied on supporting evidence of characteristic radiological changes in the sacroiliac joints, together with the Rose-Waaler and Latex tests for rheumatoid factor (RF). This distinction has remained incomplete since some 30 per cent of patients with RA may have sacroiliitis, a similar proportion having negative routine tests for RF. The identification of the HLA B27 antigen, present in 90 per cent of cases of AS and six per cent of the normal population, has enabled a number of cases to be recognized in which both diseases appear to co-exist. Ten cases are described in which either RA appears to have developed in patients with AS, or AS in patients with RA. They all fulfil the ARA diagnostic criteria for classical RA, and the criteria for classical AS. The likelihood of these two diseases occurring by chance in an individual might be of the order of 1:50,000 to 1:200,000.

Aged↗
PubMed1976

[Isolated decalcifying algodystrophy of the hip].

Transitory demineralization of the hip, a special form of reflex sympathetic dystrophy, is a rare condition. It should however be distinguished from more severe conditions such as tuberculosis or neoplastic bone disease. The typical symptoms are illustrated from 3 personally observed cases. The patients, usually men between the ages of 30 and 50 years or women in the last months of pregnancy, suffer severe mechanical pain in the hip, with limping and weakness. They usually need crutches for walking. Clinical examination of the hip reveals only slight restriction of passive movements. The erythrocyte sedimentation rate may be slightly elevated. Bone scan discloses hypercaptation, while other laboratory tests are negative. A few weeks after onset of symptoms, pelvic X-rays show extreme demineralization of the femoral head. On the other hand, the joint space and bony contours remain intact. The prognosis is excellent and the symptoms disappear after a few months or after delivery.

Accidents, Traffic↗
PubMed1976

Rheumatoid arthritis and ankylosing spondylitis occurring together.

Rheumatoid arthritis and ankylosing spondylitis are often difficult to differentiate, though it is important to do so as the natural history and treatment of the two conditions differ. Nine patients have recently been seen, each of whom fulfilled the criteria for both rheumatoid arthritis and ankylosing spondylitis. In eight of the nine patients the histocompatibility antigen HLA-27 was present. A possible explanation of these cases is that one of the diseases occurred by chance in patients already suffering from the other, but this is extremely unlikely. If a chance association is not the correct explanation the basic concepts defining rheumatoid arthritis and ankylosing spondylitis must be reconsidered.

Adult↗
PubMed1976

[Destructive arthropathies associated with articular chondrocalcinosis. Clinical and metabolic study of 16 cases].

Sixteen cases of severe destructive arthropathy in elderly persons (13 females and 3 males) suffering from articular chondrocalcinosis are described. The knee is the most commonly affected joint, followed by the hips, shoulders, wrists, elbows and feet. One joint is destroyed in seven patients, 2 joints in five, 3 joints in one and 4 joints in three patients. In 13 subjects the onset of the arthropathy was insidious, whereas 2 had only a history of previous recurrent pseudogouty attacks. Associated endocrine, neurological or metabolic diseases were ruled out by clinical examination and laboratory tests. Repeated determinations of serum calcium and phosphorus, as well as of plasma immunoreactive parathyroid hormone, were within normal limits. The possibility of hyperparathyroidism was thus an unlikely explanation for this destructive arthropathy. Its etiopathogenesis remains unclear.

Aged↗
PubMed1976

The immediate effects of intra-articular injections of osmic acid.

One hundred mg of osmic acid (with corticosteroid and lidocaine) was injected for therapeutic purposes into the knee in 10 patients suffering from various types of recalcitrant synovitis (mostly rheumatoid arthritis). The effects of this injection were followed by examination of synovial fluid, blood, and urine of these patients, collected at various intervals after intra-articular injection. As a control, a group of 3 patients (5 knees) received corticosteroid and lidocaine intra-articularly, and another group (6 patients, 7 knees) was injected with lidocaine only, both with the same total volume as the first group. Blood and urine examinations revealed essentially no effects of osmic acid, whereas in synovial fluid a strong inflammatory reaction was observed up to the second day after the injection, though the effusion soon disappeared. In a group treated with lidocaine + corticosteroid, a mild, early inflammatory reaction was noted, while lidocaine alone produced only a dilution effect, and the exudate remained relatively longer. Thus, the early local inflammatory reaction due to osmic acid is an expression of the necessary drastic effect of this beneficial therapeutic agent.

Adrenal Cortex Hormones↗
PubMed1976

A study of the incidence of articular chondrocalcinosis in Paget's disease of bone.

Amongst 66 pagetic patients, whose average age (median) was 76 years, 9 cases of ACC were found. This represents an incidence of 13.6% of the whole group. Of 72 control subjects, whose average age (median) was 73 years, 7 were found to have ACC. This represents an overall incidence of 9.7% of the control group, but the difference is not statistically significant. From this study we conclude that ACC does not occur more frequently in Paget's disease than in a group of control subjects with the same age distribution.

Aged↗
PubMed1976

Osmium deposits detected by x-ray after synoviorthesis of the knee.

A study of 113 knees of 72 patients treated with intra-articular injection of osmic acid for chronic exudative synovitis caused by various rheumatic diseases is reported. Certain cases presented abnormal radiological opacities, statistically more frequent after the injection of 200 mg than after 100 mg of osmic acid (33.9% and 15.7%). These images appear early after the injection and can remain for years. They should not be confused with intra-articular calcium deposits, or with synovial ossifications or various periosteal osteogenic processes. Their appearance does not seem to be related to the rheumatic disease treated or the therapeutic result obtained. They reflect the fixation of osmium in the synovial fatty tissue, which causes a fibrous reaction at this level. Their longterm action in the cicatrization of the synovia, or their part in a relapse of an inflammatory episode should be clarified.

Adult↗
PubMed1976

Radiological opacities of the knee after intra-articular injections of osmic acid.

Unusual radiological opacities have been observed in 29 cases after intraarticular injection of osmic acid in 113 knees of 72 patients under treatment for a chronic exudative synovitis in different types of rheumatic diseases. They are statistically more frequent after the injection of 200 mg than after 100 mg (33.9 and 15.7% respectively). Most of the time, they are located in the suprapatellar pouch. The opacities appear soon after the injection and can last for several years. They do not seem to have an unfavorable influence on the clinical course. They appear to be caused by a deposition of osmium in synovial fat tissue. From here the osmium might stimulate fibrosis. The radiological image has to be differentiated from intra-articular calcifications, synovial ossifications and various periosteal osteogenic processes.

Adult↗
PubMed1976

[Pseudo-pseudo-hypoparathyroidism (PPH) in a family: rheumatic manifestations in 3 cases, one of which associated with a tricho-rhino-phalangial syndrome (Giedion)].

Three cases of familial pseudo-pseudohypoparathyroidism (PPH) are described. Two patients presented the essential features of this rare syndrome, while the third had the signs of PPH associated with those of tricho-rhino-phalangeal dysplasia (GIEDION). All of our patients had spondylolisthesis of L5 as well as arthrosis of the hips (secondary to coxa plana in two subjects and to coxa vara in one). The phosphocalcic metabolism and determinations of serum immunoreactive parathyroid hormone were normal. The autosomal dominant genetic transmission is in agreement with observations in the literature.

Female↗
PubMed1975

Behaviour of synovial complement C3 and C4 components in inflammatory and degenerative joint diseases, before and after synoviorthesis.

The synovial fluid beta1a (C3) and beta1e (C4) expressed by their ratio to corresponding serum concentrations) were studied in 31 cases of seropositive rheumatoid arthritis (RA+), 5 cases of seronegative rheumatoid arthritis (RA-1), and 15 cases of osteoarthrosis (OA) before osmic acid synoviorthesis on knees. This was repeated after synoviorthesis in the synovial fluid (SF) of 24 RA+, 4 RA-, and 10 OA patients. The following studies were undertaken: (a) the relationship between these components; (b) their correlation with the SF protein concentration and rheumatoid factor titre, when present. This analysis led us to the following conclusions. (1) Before synoviorthesis (a) The SF beta1e is significantly lower than beta1a in RA+. In OA, an inverse phenomenon is observed. (b) The concentration of beta1a and beta1e are proportional to the protein concentration in the SF of OA. A significant inverse relationship between beta1a, beta1e, and the titre of rheumatoid factor is found. (2) after synoviorthesis the same studies performed on knees at the time of one or more relapses shows that the same pathogenetic process is involved and that the immunological mechanism is little influenced by this treatment. In OA also the relapse differs very little from the initial process observed before synoviorthesis.

Arthritis, Rheumatoid↗
PubMed1975

Xeroradiographic techniques applied to assessment of Achilles tendon in inflammatory or metabolic diseases.

Ten patients with inflammatory disease (rheumatoid arthritis, ankylosing spondylitis, Reiter's disease) or metabolic disease (gout, pseudogout, tendinous xanthomatosis) affecting the Achilles tendons are presented and discussed. Radiological lateral views of heel were obtained with xeroradiographic techniques, which permitted the recording on the same image of details of both bone and soft tissue and the evaluation and quantification of the changes in the Achilles tendons. Xeroradiography seems to be a very suitable radiological technique for routine use in the evaluation and follow up of rheumatic diseases of the foot.

Achilles Tendon↗