[Melitococcal sacro-ileitis].
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Biomedical subjects
Publications and source records attributed to J Claustre.
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The Foot, organ of the erect position and of walking is a unique example of architectural wonder, of which the slightest abnormality, static as well as dynamic may be the cause of a major dysfunction. Biomechanically, it may be summarized in two triangles: a posterior triangle, static, ensuring the erect position, and an anterior triangle, dynamic or propulsive represented by the phalangeal triangle. These two triangles are connected by a metatarso-phalangeal hinge, the harmonious curvature of which ensures the orientation and the adaptation of the foot in all directions regardless of the condition of the ground.
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Clinical and radiological examination of the foot in 25 cases of ankylosing verteral hyperostosis revealed signs of the disease in 16 cases: eleven patients had painful symptoms (predominantly pain in the heel, 9 cases) and and five had radiological changes in the feet which led to the discovery of the characteristic vertebral involvement. As for other extra-vertebral sites of vertebral hyperostosis, the foot warrants careful examination. The radiological lesions consist of osteophytic proliferations of the calcaneum (sometimes pathognomonic), scattered ossifications in the ligaments of the inferior and posterior aspects of this bone, the neck of the talus, the dorsum of the mid-foot, the internal aspect of the tarsal scaphoid or the external face of the styloid apophysis of the 5th metatarsal, and a bony proliferation enlarging the base of the distal phalanx of the big toe.
The sesamoid region constitutes an "anatomo-clinical entity" because the small sesamoid bones and the tendino-sero-cutaneous formations which surround them are in close association. Subjected to various microtraumatisms, (professional, sports or static), it expresses its pathology through a painful sesamoid point, a localized tumefaction that is more or less ifnlammatory (sometimes with a pseudo-gout aspect) or a painful corn that disturbs walking. The observation of radiologic alterations of the sesamoid bones results in the discussion of osteonecrosis (Renander's disease) or a fracture. This region may also be the site of a specific micro-cristalline inflammation (with deposit of various crystals) or a rheumatic (mainly rheumatoid, sometimes psioriatic or spondylarthritic) responsible for sesamoid alterations of variable intensity. I can also be involved in an infectious process that is either acute or chronic (fistulization). The sesamoid region has a rich pathology, that is often poorly understood since it is inadequately investigated.
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