<b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> T</span><span style="font-family:Verdana;">he <...<b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> T</span><span style="font-family:Verdana;">he </span><span style="font-family:Verdana;">o</span><span style="font-family:Verdana;">bjective is to</span><span style="font-family:""><span style="font-family:Verdana;"> determine the frequency and the semiological and evolutionary profiles of infectious spondylodiscitis in hospital practice in Kara. </span><b><span style="font-family:Verdana;">Patients</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">methods:</span></b><span style="font-family:Verdana;"> This was a cross-sectional study of a case series of patients with infectious spondylodiscitis, who were admitted to the rheumatology department of Kara University Hospital in North Togo. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Among the 3972 examined patients, 86 (33 males and 53 females) patients (2.16%) had infectious spondylodiscitis. The average age of these patients at the onset of the disease was 47.20 years. The average duration of the disease was 11.41 months. Tuberculosis was suspected in 77 of 86 patients (89.53%). The infectious spondylodiscitis most often affected the lumbar (51.04%) and dorsal (21.87%) segments and was associated with a pulmonary location in 31 patients (36.04%). In addition to underdevelopment and poor hygiene (72 cases), alcoholism (15 cases) and human immunodeficiency virus infection (10 cases) were the main risk factors identified. The progress with the medical treatment was favorable in 65 patients (75.58%) and 16 patients were lost to follow-up. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The frequency of infectious spondylodiscitis reflects the underdevelopment and poor hygiene levels in Black Africa. Its etiology is most commonly associated with tuberculosis and remains a concern despite the epidemiological transition of the different diseases.展开更多
Chronic non-specific low back pain has an important psychological impact. Objectives: To determine the prevalence of anxiety and depressive disorders (ADD) and factors associated to their apparition in patients suffer...Chronic non-specific low back pain has an important psychological impact. Objectives: To determine the prevalence of anxiety and depressive disorders (ADD) and factors associated to their apparition in patients suffering from chronic non-specific low back pain in rheumatological consultation in Lomé. Patients and Methods: It was a cross-sectional study, conducted from October 1st, 2015 to 31st March 2016. This study focused on all patients suffering from common chronic low back pain without psychiatric history in the Rheumatology Ward at the Sylvanus Olympio’s Teaching Hospital of Lomé and who have given their consent. The psychological evaluation was carried out through Hamilton scale. The processing, the statistical treatment and analysis of our data have been carried out using Epiinfo software, version 7.1.5. The investigation was approved by the local Ethics Committee. Results: 48 (39 women and 09 men) out of 123 patients with chronic lower back pain presented anxiety and depressive disorders (ADD) accounting for a prevalence rate of 39%. Their average age was 50.3 years old. The most frequent ADD was: psychic anxiety (58.6%), depressive mood (51.3%), difficulties to feel asleep (47.9%) and disturbed or agitated sleep (43.1%). Factors associated with the anxiety and depressive disorders in common chronic low back pain were: female gender (p = 0.02), dependent children (p = 0.02), occupation (reseller (p = 0.002), liberal profession (p = 0.009), monthly financial income (p = 0.002), surroundings family (0.009), medical history (p = 0.0002) and pain’s intensity > 7 (p = 0.04). Conclusion: This study shows the high frequency of anxiety and depressive disorders in common chronic low back pain and their influence by socio-economic and demographic factors.展开更多
Objectives: To determine the epidemiological, clinical and paraclinical profile of bone metastases cancer. Patients and Methods: It was a retrospective study performed on a series of cases, admitted in Rheumatology de...Objectives: To determine the epidemiological, clinical and paraclinical profile of bone metastases cancer. Patients and Methods: It was a retrospective study performed on a series of cases, admitted in Rheumatology department of the University Teaching Hospital of Lomé, Togo from October 1989 to December 2008. The diagnosis of bone metastasis was made because of the existence of inflammatory bone pain, or pathological fracture, or bone swelling and a bone condensing or mixed or osteolytic radiological image. The anatomopathological evidence was made after biopsy of the bone lesion or primary cancer. 2018 patients were hospitalized in rheumatology, and among them 77 had documented bone metastasis. Results: There were 53 men (68.8%) and 24 women (31.2%) with a sex ratio of 2.2. The mean age was 56.6 ± 12.6 years, ranging from 21 to 82 years. The primary cancer most frequently found was that of the prostate, representing 57.1% of bone metastasis and breast in 15.6%. The main manifestations of patients with bone metastases were inflammatory bone pain (76.6%) and alteration of general condition (75.3%). The spine was the main area of pain (64.9%). The metastasis was bone condensing in 48.1% of cases, osteolytic in 40.3% and mixed in 11.6%. The average survival was 22 months. Conclusion: The clinical and radiological presentation remains classic. Cancer of the prostate and breast are the main neoplasia responsible for bone metastasis in our series. The diagnosis of the primary tumor is often made at the stage of metastasis in black Africa.展开更多
Objective: To compare the epidemiological, the clinical and the paraclinical profile of osteoarticular infections in HIV-positive patients and in HIV-negative patients. Patients and Methods: patients with Osteoarticul...Objective: To compare the epidemiological, the clinical and the paraclinical profile of osteoarticular infections in HIV-positive patients and in HIV-negative patients. Patients and Methods: patients with Osteoarticular infections recognized on the basis of radioclinical and epidemiological arguments were included in this study. The comparison that was based on the existence or was not of HIV infection focused on various clinical and biological components. Of these 15,800 rheumatic patients admitted in 18 years, 461 have suffered from Osteoarticular infection (2.9%). The 461 patient objects of this study were divided into 235 cases of infectious arthritis including 38 cases of co-infection with HIV and 225 cases of infectious spondylodiscitis including 21 cases of HIV co-infection. Results: There were 246 women (53.4%) and 215 men (46.4%) with a sex ratio of 1.1. The mean age was 37.7 ± 13.6 years. The data comparison of HIV-negative patients and HIV-positive patients had not shown statistically significant difference in the infectious spondylodiscitis group and in the group of infectious arthritis patients. Only fever was statistically significant in both groups and weight loss in the group of infectious arthritis (p < 0.001). Conclusion: HIV seems not to particularly influence the semiological profile of Osteoarticular infections in Lomé.展开更多
Aim: Determine the frequency and respective proportion of the various etiological forms of arthritis in Lomé (Togo). Patients and Methods: Transversal study carried out over 15 years on files of arthritis infecte...Aim: Determine the frequency and respective proportion of the various etiological forms of arthritis in Lomé (Togo). Patients and Methods: Transversal study carried out over 15 years on files of arthritis infected patients and submitted to rheumatologic consultation. Results: 1081 out of 13,517 patients examined (8%) were suffering from arthritis. Those 1081 patients (456 women, 42.2% and 625 men, 57.8%) were in average 38 years old and enjoyed an average duration of evolution of three years. The chronic inflammatory rheumatisms (CIR) (602 cases, 56.9%), the metabolic arthropathies (233 cases, 22%) and the infections (198 cases, 16.6%), were the main etiologies that were observed. The average age of 198 patients with infectious arthritis was 36 years and the average duration of 9 months. Infectious arthritis was preferably located at the knee (34.3%), and was essentially caused by a banal germ (157 patients;79.3%) and associated with HIV in 25 patients (15.9%). The remaining 233 patients (9 women, and 224 men) suffering from metabolic arthritis were in average 52 years old and enjoyed an average duration of evolution of five years. The chronic inflammatory rheumatisms were mainly represented by spondyloarthropathies (90 cases, 14.9%) and the arthritis rheumatoid (64 cases, 10.6%). 399 out of 602 cases of the CIR were not classified while 52 cases were associated with HIV. The connective tissue diseases were dominated by the polymyositis (9 cases, 18.7%). Conclusion: The chronic inflammatory rheumatisms were the first causal form of arthritis in rheumatologic consultation in Lomé.展开更多
Objectives: Therapeutic compliance can be defined as the degree of adequacy between a patient’s behaviour and his doctor’s recommendations. Non-adherence to treatment has serious consequences in terms of morbidity a...Objectives: Therapeutic compliance can be defined as the degree of adequacy between a patient’s behaviour and his doctor’s recommendations. Non-adherence to treatment has serious consequences in terms of morbidity and mortality. Our aim was to assess adherence among patients treated for chronic inflammatory rheumatism in Lomé. Patients and Methods: This was a multicentre cross-sectional study conducted from January 2015 to December 2021. Patients aged 18 years or older, treated in the rheumatology departments of the Sylvanus Olympio University Hospital or the Bè Hospital during the study period, were included if they were diagnosed with chronic inflammatory rheumatism and started on disease-modifying therapy. Adherence was assessed using the Compliance Questionnaire Rheumatology 19 questionnaire, with a threshold for good compliance set at 80%. Results: Out of 13,214 patients received, 159 suffered from chronic inflammatory rheumatism (hospital frequency 1.5%), and 60 met the inclusion criteria for our study. There were 55 women (91.7%) and 5 men (8.3%), giving a sex-ratio of 1/11. The mean age was 49.5 ± 13.5 years (extremes: 19 and 78 years). Rheumatoid arthritis (68.3%) was the most common rheumatic disease, followed by undefined rheumatic diseases (16.6%) and spondyloarthritis (8.3%). Average compliance with treatment was 76.9% ± 12.4% (extremes 29.8 and 91.2). There was no statistically significant difference according to the type of rheumatism. Conclusion: Overall compliance was poor, with a Compliance Questionnaire Rheumatology 19 of less than 80%. It was non-significantly influenced by socioeconomic status, disease severity and duration of progression.展开更多
Infectious spondylodiscitis in the elderly is a diagnostic and therapeutic emergency. They are mainly a functional and sometimes vital prognosis issue, with long-term chronic disabling sequelae and significant social ...Infectious spondylodiscitis in the elderly is a diagnostic and therapeutic emergency. They are mainly a functional and sometimes vital prognosis issue, with long-term chronic disabling sequelae and significant social costs. Study aim: To describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of infectious spondylodiscitis in the elderly in a rheumatological setting in Togo. Patients and methods: This was a multicenter, cross-sectional study conducted on the records of patients aged at least 65 years, suffering from infectious spondylodiscitis and hospitalized in four rheumatology units from their respective opening dates till December 31, 2020. Data collection lasted three months (December 1, 2020 to February 29, 2021). The diagnosis of infectious spondylodiscitis was radioclinical and laboratory-based. Results: 83 (49 women, 34 men) of the 1281 patients (6.48%) examined had infectious spondylodiscitis. The mean age at consultation was 70.59 ± 5.09 years, and the mean duration of the clinical course was 12 months. Spondylodiscitis was of tuberculous etiology (89.20%). It was most often found in the lumbar (56.62%) and dorsal (21.69%) segments. The location was multifocal in 12.05% of cases. It was associated with pulmonary involvement in 22.64% of cases. A neurological complication was identified in 48.19%. The main risk factors identified were promiscuity (48.82%), chronic alcoholism (18.07%), HIV infection (8.43%), diabetes (6.03%) and sickle cell disease (6.03%). The clinical course under medical treatment was favorable in 57 patients (68.68%). Conclusion: Infectious spondylodiscitis remains a frequent reason for hospitalization, tuberculosis being the most frequent etiology. Multifocal location, deterioration of general condition, gibbosity and neurological complications are exclusive to the elderly subject.展开更多
Objectives: To determine the frequency, the clinical and radiological features of lumbar spondylolisthesis in a rheumatological practice in Lomé. Patients and methods: This was a cross-sectional study conducted i...Objectives: To determine the frequency, the clinical and radiological features of lumbar spondylolisthesis in a rheumatological practice in Lomé. Patients and methods: This was a cross-sectional study conducted in the rheumatology department of the Sylvanus Olympio Teaching Hospital in Lomé between January 1997 and December 2019. Medical records of patients with symptomatic spondylolisthesis with radiographic confirmation were reviewed. The Meyerding classification system was used for grading. Results: Of the 350 patients contacted, 118 consented to participate in the study, making a response rate of 33.71%. Of the 118, 104 (88.1%) were females. 109 (92.4%) presented with radicular pain and 9 (7.6%) presented low back pain. The mean age of the patients was 54.24 ± 11.19 years. The average duration of the pain was 4.56 ± 1.32 years. The spondylolisthesis level most involved was the L4 - L5 (92/118), followed by L5 - S1 (23/118). 106 (89.8%) patients had anterolisthesis only, seven (5.9%) combination anterolisthesis and retrolisthesis. The spondylolisthesis was associated with spondylosis in 110 (93.2%) patients. Spondylosis was found at level L4 - L5 in 38.98% patients, followed by L5 - S1 (24.58%), L3 - L4 (18.64%). Grade I slip was found in 108 (91.53%) patients and Grade II slips 10 (8.47%). Isthmic lysis was found in 40 (33.9%) patients and it was located at L4 in 30 (75.0%). Conclusion: Lumbar spondylolisthesis appears to be expected in Lomé patients with nonspecific back pain and mainly affects females.展开更多
Chronic inflammatory rheumatism is a pathology of variable frequency and severity with a significant impact on the socio-economic, personal and family level. Study Aim: To describe the epidemiological, clinical, labor...Chronic inflammatory rheumatism is a pathology of variable frequency and severity with a significant impact on the socio-economic, personal and family level. Study Aim: To describe the epidemiological, clinical, laboratory, radiological, therapeutic and evolutive features of chronic inflammatory rheumatic diseases in rheumatological practice in Togo. Patients and Methods: This was a multicenter cross-sectional study conducted from January 2011 to December 2019 on patients examined in the three rheumatology departments in Lomé (Togo). Patients 18 years old and above who have presented joint pain with or without synovitis, and/or rachialgia (back pain) for at least three months were included. The diagnosis of chronic inflammatory rheumatic diseases was made according to international consensus criteria. Results: Out of the 20333 patients whose files were collected during our study period, 290 (1.43%) suffered from chronic inflammatory rheumatic diseases. There were 226 (77.93%) females and 64 (22.07%) males. The mean age of the patients was 42.79 ± 15.18 years. The mean duration of symptoms was 40.80 ± 54.09 months. Arthritis (67.24%) was the main reason for consultation, followed by joint pain (31.38%). rheumatoid arthritis (41.03%), unclassified chronic inflammatory rheumatic diseases (38.62%), spondyloarthropathies (15.17%) and systemic lupus erythematosus (2.41%) were the major clinical forms. The immunological tests performed in 13.79% of cases were positive in 52.94% of cases. Carpitis (57.55%) and diffuse osteoporosis (45.28%) were the commonest radiographic features of the hands. 289 patients (99.66%) received symptomatic treatments such as NSAIDs (73.36%) and corticosteroids (51.90%) and 90 patients (31.03%) were treated with synthetic DMARDs such as methotrexate (88.89%). The outcome was favorable in 27.93% of cases. Conclusion: Chronic inflammatory rheumatic diseases are common diseases in rheumatological practice in Togo that deserve special attention. The establishment of a specialized immunology laboratory could be very useful for the diagnosis and early management of these diseases.展开更多
<span style="font-family:Verdana;"><strong>Objectives: </strong>To determine the epidemiological, clinical, and bacteriological characteristics of septic arthritis of the hip (SAH) among pa...<span style="font-family:Verdana;"><strong>Objectives: </strong>To determine the epidemiological, clinical, and bacteriological characteristics of septic arthritis of the hip (SAH) among patients hospitalized in the departments of Rheumatology in Lomé. <strong>Patients and Methods:</strong> This was a multicentre, descriptive study, conducted over a 16-year period, from January 2004 to December 2020 on patients’ records at the three departments of Rheumatology in Lomé. We included in this study only patients with complete laboratory and radiological data. Patients who underwent hip replacement surgery and those with arthritis of the hip due to all inflammatory arthropathies were excluded. The diagnosis of SAH was based on clinical, radiological and bacteriological features. In the absence of bacteriological confirmation, the presumptive etiological diagnosis was based on epidemiological data, contacting with a person with tuberculosis, the presence of high-grade fever, the mode of presentation of the symptoms, the patient’s general appearance, and the result of the tuberculin skin test. The data was collected using Epi info 7.0 and statistical analysis was performed using STATA/IC 11.0. <strong>Results:</strong> Out of 3776 patients hospitalized in the three departments over the study period, 705 (18.67%) were diagnosed with septic arthritis of which 70 (9.92%) patients with SAH. The 70 patients with SAH were 44 (62.86%) females, and 26 (37.14%) males, with a sex ratio of 1.7 F/M. The mean age of the patients was 42.43 ± 19.37 years (range: 5 years and 80 years) and the mean duration of symptoms was 6.57 ± 8.85 months (range: 2 days and 48 months). The pain was inflammatory in nature in 46 (65.71%) and mechanical in nature in 24 (34.29%) patients. The onset of the disease was progressive in 50 (71.43%) patients and sudden in 20 (28.57%) patients. The locations of the pain were: groin only 25 (35.71%), greater trochanter only 15 (21.43%), groin and lower back 14 (20%), and groin and greater trochanter 9 (12.86%). Sixty-four patients (91.43%) were limping and only six (08.57%) were crippled. Weight loss was noted in 38 (54.29%) patients. A risk factor was identified in 63 (90.00%) patients;they were chronic alcohol abuse 24 (34.29%), poor hygiene 17 (24.29%), sickle cell disease 13 (18.57%), HIV infection five (7.14%), and diabetes four (05.71%). Radiologic features suggestive of SAH were seen on plain radiograph and computed tomography in 55 (78.57%) and 15 (21.43%) patients, respectively. The SAH was unilateral (48 right hip and 20 left hip) in 68 (97.14%) patients and bilateral in two (02.86%) patients. The diagnosis of SAH was probable tuberculosis in 46 (65.71%) patients and probable pyogenic bacteria in 24 (34.29%) patients. The outcome was favourable in 68 (97.14%) patients and two (02.86%) patients died. <strong>Conclusion:</strong> The hip remains a relatively rare localization of infectious pathologies. Most cases of SAH are due to tuberculosis.</span>展开更多
<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:""><span style="font-family:Verdana;">: Hepatocarcinoma is the...<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:""><span style="font-family:Verdana;">: Hepatocarcinoma is the most common primary malignant tumor of the liver with rare bone metastases, electively residing in the vertebrae, ribs and sternum. They remain exceptionally revealing. </span><b><span style="font-family:Verdana;">Cases</span></b> <b><span style="font-family:Verdana;">reports</span></b><span style="font-family:Verdana;">: We report two cases of bone metastases indicative of hepatocellular carcinoma in patients with viral hepatitis C. Through these two observations, we describe the various clinical, paraclinical and therapeutic aspects of this condition </span><span><span style="font-family:Verdana;">whose prognosis is poor. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: Although unusual, osteolytic bone</span></span><span style="font-family:Verdana;"> metastases may be indicative of hepatocellular carcinoma</span></span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the diagnosis must be made in the event of any tumor bone involvement in a patient with chronic liver disease, particularly viral.展开更多
Background: The reel impact of malignant bone tumors in adults seems unclear in Black Africa. Aim: The aim of this study is to determine the epidemiological and the semiological profile of malignant bone tumors in rhe...Background: The reel impact of malignant bone tumors in adults seems unclear in Black Africa. Aim: The aim of this study is to determine the epidemiological and the semiological profile of malignant bone tumors in rheumatology inpatients at Hospital University Center Sylvanus Olympio in Lome. Methods: It was a retrospective study of recorded cases conducted over a period of 19 years in the rheumatology department at Hospital University center Sylvanus Olympio in Lome, Togo. Results: One hundred and sixty-six patients (68 women and 98 men) suffered from a bone tumor. The average age of patients was 55 years old with some extremes cases of 14 and 98 years old. The most affected age group was the one between 46 and 55 years old (40 cases, 24.1%). The disease’s average duration was 17 months. These tumors were primary in 43 cases (26%) and secondary in 123 (74%). Metastases were those of prostate (44 cases, 35.7%), breast (12 cases, 9.7%), bronchus (7 cases, 5.7%), cervix (5.7%), and liver (2 cases, 1.6%). Myeloma (34 cases;79.0%) and osteosarcoma (9 cases;20.9%) were the main primary malignant bone tumors. However, 41 cases (33.3%) of malignant bone tumors had not been able to label. The spine was the predilection part for all above-mentioned tumors. Conclusion: This study shows the significant part occupied by malignant bone tumors in musculoskeletal diseases within the sub-Saharan population in general and Togo in particular.展开更多
文摘<b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> T</span><span style="font-family:Verdana;">he </span><span style="font-family:Verdana;">o</span><span style="font-family:Verdana;">bjective is to</span><span style="font-family:""><span style="font-family:Verdana;"> determine the frequency and the semiological and evolutionary profiles of infectious spondylodiscitis in hospital practice in Kara. </span><b><span style="font-family:Verdana;">Patients</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">methods:</span></b><span style="font-family:Verdana;"> This was a cross-sectional study of a case series of patients with infectious spondylodiscitis, who were admitted to the rheumatology department of Kara University Hospital in North Togo. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Among the 3972 examined patients, 86 (33 males and 53 females) patients (2.16%) had infectious spondylodiscitis. The average age of these patients at the onset of the disease was 47.20 years. The average duration of the disease was 11.41 months. Tuberculosis was suspected in 77 of 86 patients (89.53%). The infectious spondylodiscitis most often affected the lumbar (51.04%) and dorsal (21.87%) segments and was associated with a pulmonary location in 31 patients (36.04%). In addition to underdevelopment and poor hygiene (72 cases), alcoholism (15 cases) and human immunodeficiency virus infection (10 cases) were the main risk factors identified. The progress with the medical treatment was favorable in 65 patients (75.58%) and 16 patients were lost to follow-up. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The frequency of infectious spondylodiscitis reflects the underdevelopment and poor hygiene levels in Black Africa. Its etiology is most commonly associated with tuberculosis and remains a concern despite the epidemiological transition of the different diseases.
文摘Chronic non-specific low back pain has an important psychological impact. Objectives: To determine the prevalence of anxiety and depressive disorders (ADD) and factors associated to their apparition in patients suffering from chronic non-specific low back pain in rheumatological consultation in Lomé. Patients and Methods: It was a cross-sectional study, conducted from October 1st, 2015 to 31st March 2016. This study focused on all patients suffering from common chronic low back pain without psychiatric history in the Rheumatology Ward at the Sylvanus Olympio’s Teaching Hospital of Lomé and who have given their consent. The psychological evaluation was carried out through Hamilton scale. The processing, the statistical treatment and analysis of our data have been carried out using Epiinfo software, version 7.1.5. The investigation was approved by the local Ethics Committee. Results: 48 (39 women and 09 men) out of 123 patients with chronic lower back pain presented anxiety and depressive disorders (ADD) accounting for a prevalence rate of 39%. Their average age was 50.3 years old. The most frequent ADD was: psychic anxiety (58.6%), depressive mood (51.3%), difficulties to feel asleep (47.9%) and disturbed or agitated sleep (43.1%). Factors associated with the anxiety and depressive disorders in common chronic low back pain were: female gender (p = 0.02), dependent children (p = 0.02), occupation (reseller (p = 0.002), liberal profession (p = 0.009), monthly financial income (p = 0.002), surroundings family (0.009), medical history (p = 0.0002) and pain’s intensity > 7 (p = 0.04). Conclusion: This study shows the high frequency of anxiety and depressive disorders in common chronic low back pain and their influence by socio-economic and demographic factors.
文摘Objectives: To determine the epidemiological, clinical and paraclinical profile of bone metastases cancer. Patients and Methods: It was a retrospective study performed on a series of cases, admitted in Rheumatology department of the University Teaching Hospital of Lomé, Togo from October 1989 to December 2008. The diagnosis of bone metastasis was made because of the existence of inflammatory bone pain, or pathological fracture, or bone swelling and a bone condensing or mixed or osteolytic radiological image. The anatomopathological evidence was made after biopsy of the bone lesion or primary cancer. 2018 patients were hospitalized in rheumatology, and among them 77 had documented bone metastasis. Results: There were 53 men (68.8%) and 24 women (31.2%) with a sex ratio of 2.2. The mean age was 56.6 ± 12.6 years, ranging from 21 to 82 years. The primary cancer most frequently found was that of the prostate, representing 57.1% of bone metastasis and breast in 15.6%. The main manifestations of patients with bone metastases were inflammatory bone pain (76.6%) and alteration of general condition (75.3%). The spine was the main area of pain (64.9%). The metastasis was bone condensing in 48.1% of cases, osteolytic in 40.3% and mixed in 11.6%. The average survival was 22 months. Conclusion: The clinical and radiological presentation remains classic. Cancer of the prostate and breast are the main neoplasia responsible for bone metastasis in our series. The diagnosis of the primary tumor is often made at the stage of metastasis in black Africa.
文摘Objective: To compare the epidemiological, the clinical and the paraclinical profile of osteoarticular infections in HIV-positive patients and in HIV-negative patients. Patients and Methods: patients with Osteoarticular infections recognized on the basis of radioclinical and epidemiological arguments were included in this study. The comparison that was based on the existence or was not of HIV infection focused on various clinical and biological components. Of these 15,800 rheumatic patients admitted in 18 years, 461 have suffered from Osteoarticular infection (2.9%). The 461 patient objects of this study were divided into 235 cases of infectious arthritis including 38 cases of co-infection with HIV and 225 cases of infectious spondylodiscitis including 21 cases of HIV co-infection. Results: There were 246 women (53.4%) and 215 men (46.4%) with a sex ratio of 1.1. The mean age was 37.7 ± 13.6 years. The data comparison of HIV-negative patients and HIV-positive patients had not shown statistically significant difference in the infectious spondylodiscitis group and in the group of infectious arthritis patients. Only fever was statistically significant in both groups and weight loss in the group of infectious arthritis (p < 0.001). Conclusion: HIV seems not to particularly influence the semiological profile of Osteoarticular infections in Lomé.
文摘Aim: Determine the frequency and respective proportion of the various etiological forms of arthritis in Lomé (Togo). Patients and Methods: Transversal study carried out over 15 years on files of arthritis infected patients and submitted to rheumatologic consultation. Results: 1081 out of 13,517 patients examined (8%) were suffering from arthritis. Those 1081 patients (456 women, 42.2% and 625 men, 57.8%) were in average 38 years old and enjoyed an average duration of evolution of three years. The chronic inflammatory rheumatisms (CIR) (602 cases, 56.9%), the metabolic arthropathies (233 cases, 22%) and the infections (198 cases, 16.6%), were the main etiologies that were observed. The average age of 198 patients with infectious arthritis was 36 years and the average duration of 9 months. Infectious arthritis was preferably located at the knee (34.3%), and was essentially caused by a banal germ (157 patients;79.3%) and associated with HIV in 25 patients (15.9%). The remaining 233 patients (9 women, and 224 men) suffering from metabolic arthritis were in average 52 years old and enjoyed an average duration of evolution of five years. The chronic inflammatory rheumatisms were mainly represented by spondyloarthropathies (90 cases, 14.9%) and the arthritis rheumatoid (64 cases, 10.6%). 399 out of 602 cases of the CIR were not classified while 52 cases were associated with HIV. The connective tissue diseases were dominated by the polymyositis (9 cases, 18.7%). Conclusion: The chronic inflammatory rheumatisms were the first causal form of arthritis in rheumatologic consultation in Lomé.
文摘Objectives: Therapeutic compliance can be defined as the degree of adequacy between a patient’s behaviour and his doctor’s recommendations. Non-adherence to treatment has serious consequences in terms of morbidity and mortality. Our aim was to assess adherence among patients treated for chronic inflammatory rheumatism in Lomé. Patients and Methods: This was a multicentre cross-sectional study conducted from January 2015 to December 2021. Patients aged 18 years or older, treated in the rheumatology departments of the Sylvanus Olympio University Hospital or the Bè Hospital during the study period, were included if they were diagnosed with chronic inflammatory rheumatism and started on disease-modifying therapy. Adherence was assessed using the Compliance Questionnaire Rheumatology 19 questionnaire, with a threshold for good compliance set at 80%. Results: Out of 13,214 patients received, 159 suffered from chronic inflammatory rheumatism (hospital frequency 1.5%), and 60 met the inclusion criteria for our study. There were 55 women (91.7%) and 5 men (8.3%), giving a sex-ratio of 1/11. The mean age was 49.5 ± 13.5 years (extremes: 19 and 78 years). Rheumatoid arthritis (68.3%) was the most common rheumatic disease, followed by undefined rheumatic diseases (16.6%) and spondyloarthritis (8.3%). Average compliance with treatment was 76.9% ± 12.4% (extremes 29.8 and 91.2). There was no statistically significant difference according to the type of rheumatism. Conclusion: Overall compliance was poor, with a Compliance Questionnaire Rheumatology 19 of less than 80%. It was non-significantly influenced by socioeconomic status, disease severity and duration of progression.
文摘Infectious spondylodiscitis in the elderly is a diagnostic and therapeutic emergency. They are mainly a functional and sometimes vital prognosis issue, with long-term chronic disabling sequelae and significant social costs. Study aim: To describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of infectious spondylodiscitis in the elderly in a rheumatological setting in Togo. Patients and methods: This was a multicenter, cross-sectional study conducted on the records of patients aged at least 65 years, suffering from infectious spondylodiscitis and hospitalized in four rheumatology units from their respective opening dates till December 31, 2020. Data collection lasted three months (December 1, 2020 to February 29, 2021). The diagnosis of infectious spondylodiscitis was radioclinical and laboratory-based. Results: 83 (49 women, 34 men) of the 1281 patients (6.48%) examined had infectious spondylodiscitis. The mean age at consultation was 70.59 ± 5.09 years, and the mean duration of the clinical course was 12 months. Spondylodiscitis was of tuberculous etiology (89.20%). It was most often found in the lumbar (56.62%) and dorsal (21.69%) segments. The location was multifocal in 12.05% of cases. It was associated with pulmonary involvement in 22.64% of cases. A neurological complication was identified in 48.19%. The main risk factors identified were promiscuity (48.82%), chronic alcoholism (18.07%), HIV infection (8.43%), diabetes (6.03%) and sickle cell disease (6.03%). The clinical course under medical treatment was favorable in 57 patients (68.68%). Conclusion: Infectious spondylodiscitis remains a frequent reason for hospitalization, tuberculosis being the most frequent etiology. Multifocal location, deterioration of general condition, gibbosity and neurological complications are exclusive to the elderly subject.
文摘Objectives: To determine the frequency, the clinical and radiological features of lumbar spondylolisthesis in a rheumatological practice in Lomé. Patients and methods: This was a cross-sectional study conducted in the rheumatology department of the Sylvanus Olympio Teaching Hospital in Lomé between January 1997 and December 2019. Medical records of patients with symptomatic spondylolisthesis with radiographic confirmation were reviewed. The Meyerding classification system was used for grading. Results: Of the 350 patients contacted, 118 consented to participate in the study, making a response rate of 33.71%. Of the 118, 104 (88.1%) were females. 109 (92.4%) presented with radicular pain and 9 (7.6%) presented low back pain. The mean age of the patients was 54.24 ± 11.19 years. The average duration of the pain was 4.56 ± 1.32 years. The spondylolisthesis level most involved was the L4 - L5 (92/118), followed by L5 - S1 (23/118). 106 (89.8%) patients had anterolisthesis only, seven (5.9%) combination anterolisthesis and retrolisthesis. The spondylolisthesis was associated with spondylosis in 110 (93.2%) patients. Spondylosis was found at level L4 - L5 in 38.98% patients, followed by L5 - S1 (24.58%), L3 - L4 (18.64%). Grade I slip was found in 108 (91.53%) patients and Grade II slips 10 (8.47%). Isthmic lysis was found in 40 (33.9%) patients and it was located at L4 in 30 (75.0%). Conclusion: Lumbar spondylolisthesis appears to be expected in Lomé patients with nonspecific back pain and mainly affects females.
文摘Chronic inflammatory rheumatism is a pathology of variable frequency and severity with a significant impact on the socio-economic, personal and family level. Study Aim: To describe the epidemiological, clinical, laboratory, radiological, therapeutic and evolutive features of chronic inflammatory rheumatic diseases in rheumatological practice in Togo. Patients and Methods: This was a multicenter cross-sectional study conducted from January 2011 to December 2019 on patients examined in the three rheumatology departments in Lomé (Togo). Patients 18 years old and above who have presented joint pain with or without synovitis, and/or rachialgia (back pain) for at least three months were included. The diagnosis of chronic inflammatory rheumatic diseases was made according to international consensus criteria. Results: Out of the 20333 patients whose files were collected during our study period, 290 (1.43%) suffered from chronic inflammatory rheumatic diseases. There were 226 (77.93%) females and 64 (22.07%) males. The mean age of the patients was 42.79 ± 15.18 years. The mean duration of symptoms was 40.80 ± 54.09 months. Arthritis (67.24%) was the main reason for consultation, followed by joint pain (31.38%). rheumatoid arthritis (41.03%), unclassified chronic inflammatory rheumatic diseases (38.62%), spondyloarthropathies (15.17%) and systemic lupus erythematosus (2.41%) were the major clinical forms. The immunological tests performed in 13.79% of cases were positive in 52.94% of cases. Carpitis (57.55%) and diffuse osteoporosis (45.28%) were the commonest radiographic features of the hands. 289 patients (99.66%) received symptomatic treatments such as NSAIDs (73.36%) and corticosteroids (51.90%) and 90 patients (31.03%) were treated with synthetic DMARDs such as methotrexate (88.89%). The outcome was favorable in 27.93% of cases. Conclusion: Chronic inflammatory rheumatic diseases are common diseases in rheumatological practice in Togo that deserve special attention. The establishment of a specialized immunology laboratory could be very useful for the diagnosis and early management of these diseases.
文摘<span style="font-family:Verdana;"><strong>Objectives: </strong>To determine the epidemiological, clinical, and bacteriological characteristics of septic arthritis of the hip (SAH) among patients hospitalized in the departments of Rheumatology in Lomé. <strong>Patients and Methods:</strong> This was a multicentre, descriptive study, conducted over a 16-year period, from January 2004 to December 2020 on patients’ records at the three departments of Rheumatology in Lomé. We included in this study only patients with complete laboratory and radiological data. Patients who underwent hip replacement surgery and those with arthritis of the hip due to all inflammatory arthropathies were excluded. The diagnosis of SAH was based on clinical, radiological and bacteriological features. In the absence of bacteriological confirmation, the presumptive etiological diagnosis was based on epidemiological data, contacting with a person with tuberculosis, the presence of high-grade fever, the mode of presentation of the symptoms, the patient’s general appearance, and the result of the tuberculin skin test. The data was collected using Epi info 7.0 and statistical analysis was performed using STATA/IC 11.0. <strong>Results:</strong> Out of 3776 patients hospitalized in the three departments over the study period, 705 (18.67%) were diagnosed with septic arthritis of which 70 (9.92%) patients with SAH. The 70 patients with SAH were 44 (62.86%) females, and 26 (37.14%) males, with a sex ratio of 1.7 F/M. The mean age of the patients was 42.43 ± 19.37 years (range: 5 years and 80 years) and the mean duration of symptoms was 6.57 ± 8.85 months (range: 2 days and 48 months). The pain was inflammatory in nature in 46 (65.71%) and mechanical in nature in 24 (34.29%) patients. The onset of the disease was progressive in 50 (71.43%) patients and sudden in 20 (28.57%) patients. The locations of the pain were: groin only 25 (35.71%), greater trochanter only 15 (21.43%), groin and lower back 14 (20%), and groin and greater trochanter 9 (12.86%). Sixty-four patients (91.43%) were limping and only six (08.57%) were crippled. Weight loss was noted in 38 (54.29%) patients. A risk factor was identified in 63 (90.00%) patients;they were chronic alcohol abuse 24 (34.29%), poor hygiene 17 (24.29%), sickle cell disease 13 (18.57%), HIV infection five (7.14%), and diabetes four (05.71%). Radiologic features suggestive of SAH were seen on plain radiograph and computed tomography in 55 (78.57%) and 15 (21.43%) patients, respectively. The SAH was unilateral (48 right hip and 20 left hip) in 68 (97.14%) patients and bilateral in two (02.86%) patients. The diagnosis of SAH was probable tuberculosis in 46 (65.71%) patients and probable pyogenic bacteria in 24 (34.29%) patients. The outcome was favourable in 68 (97.14%) patients and two (02.86%) patients died. <strong>Conclusion:</strong> The hip remains a relatively rare localization of infectious pathologies. Most cases of SAH are due to tuberculosis.</span>
文摘<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:""><span style="font-family:Verdana;">: Hepatocarcinoma is the most common primary malignant tumor of the liver with rare bone metastases, electively residing in the vertebrae, ribs and sternum. They remain exceptionally revealing. </span><b><span style="font-family:Verdana;">Cases</span></b> <b><span style="font-family:Verdana;">reports</span></b><span style="font-family:Verdana;">: We report two cases of bone metastases indicative of hepatocellular carcinoma in patients with viral hepatitis C. Through these two observations, we describe the various clinical, paraclinical and therapeutic aspects of this condition </span><span><span style="font-family:Verdana;">whose prognosis is poor. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: Although unusual, osteolytic bone</span></span><span style="font-family:Verdana;"> metastases may be indicative of hepatocellular carcinoma</span></span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the diagnosis must be made in the event of any tumor bone involvement in a patient with chronic liver disease, particularly viral.
文摘Background: The reel impact of malignant bone tumors in adults seems unclear in Black Africa. Aim: The aim of this study is to determine the epidemiological and the semiological profile of malignant bone tumors in rheumatology inpatients at Hospital University Center Sylvanus Olympio in Lome. Methods: It was a retrospective study of recorded cases conducted over a period of 19 years in the rheumatology department at Hospital University center Sylvanus Olympio in Lome, Togo. Results: One hundred and sixty-six patients (68 women and 98 men) suffered from a bone tumor. The average age of patients was 55 years old with some extremes cases of 14 and 98 years old. The most affected age group was the one between 46 and 55 years old (40 cases, 24.1%). The disease’s average duration was 17 months. These tumors were primary in 43 cases (26%) and secondary in 123 (74%). Metastases were those of prostate (44 cases, 35.7%), breast (12 cases, 9.7%), bronchus (7 cases, 5.7%), cervix (5.7%), and liver (2 cases, 1.6%). Myeloma (34 cases;79.0%) and osteosarcoma (9 cases;20.9%) were the main primary malignant bone tumors. However, 41 cases (33.3%) of malignant bone tumors had not been able to label. The spine was the predilection part for all above-mentioned tumors. Conclusion: This study shows the significant part occupied by malignant bone tumors in musculoskeletal diseases within the sub-Saharan population in general and Togo in particular.
