[Value of combined bone and synovial membrane biopsy in the diagnosis of rheumatic hip diseases].
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Biomedical subjects
Publications and source records attributed to R Durroux.
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The authors report 4 cases of rheumatoid psoriasis in which involvement of the great toe, associating psoriatic onychosis, thickening of the distal soft tissues and osteo-periostitis of the distal phalanx without lesions of the interphalangeal joint, is the result of a direct repercussion of the ungual lesion on the distal phalanx. This is explained by very close anatomic links between nail and distal phalanx. They advocate the term of psoriatic onycho-pachydermo-periostitis of the great toe or OP3GT, when referring to this radio-clinical syndrome highly evocative of rheumatoid psoriasis.
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Iliac bone biopsy, including a quantitative study, was carried out in 38 patients with primary hyperparathyroidism (34 surgical patients, 4 with typical syndromes based on laboratory analysis). A second biopsy was carried out in 7 cases. By studying both the surface resorption of the strands of the spongy tissue and periosteocyte osteolysis (an indirect measure by assessment of the surface aera of the periosteocyte lacunae), it is possible to arrive at a histological diagnosis of hyperparathyroidism in 98 percent of cases: surface resorption is increased in 82 percent of cases; the periosteocyte lacunae are enlarged in 91 percent of cases; the two criteria together give a positive result in 44 cases out of 45 (98 percent). This morphometric study is particularly valuable in those cases in which the qualitative histological appearance is not very informative.