Rectus femoris sheath: a new localization of hip synovial cyst

Iliopsoas bursitis is the classical manifestation of synovial cysts of the hip. We report the first observation of a new localization of these cysts: the sheath of rectus femoris muscle. The patient presented with a hip osteoarthritis and an important mass of the front of the thigh. Computed tomography was useful in establishing the diagnosis and hip arthrography confirmed the communication between the joint and the rectus femoris sheath.

[Antibody activity of monoclonal immunoglobulins]

Monoclonal immunoglobulins present a normal structure and have an antibody activity. This activity may be directed against exo-antigens especially bacterial, but more frequently against auto-antigens. It may then be symptomatic and therefore explain unusual clinical or biological manifestations in the course of monoclonal dysglobulinemias; but, most of the time, the monoclonal auto-antibody activity is asymptomatic and polyspecific, as it is only the monoclonal expression of polyclonal natural auto-antibodies. A comprehensive review of the various antibody activities of monoclonal immunoglobulins is presented. With the presence, in large quantities, of monoclonal immunoglobulins and their antibody activity, the links between dysglobulinemia and autoimmune disease are discussed as well as the pathogenic role of auto-antibodies.

[The percentage of bone marrow plasmacytes and prognosis in multiple myeloma]

The degree of medullary infiltration by plasmocytes has a prognostic value which completes the clinical classifications proposed in multiple myeloma. Beyond a 50 p. cent medullary infiltration, the mean survival of the patients is significantly shorter (p less than 0.02) than survival of patients presenting less than 50 p. cent medullary infiltration. The degree of medullary infiltration is unrelated to the stage of Durie and Salmon classification, but is correlated to the degree of differentiation of the plasmocytes.

[Assay of erythrocyte, platelet and serum superoxide dismutase, glutathione peroxidase and catalase in rheumatoid polyarthritis]

The authors present a study of superoxide dismutase, catalase and glutathione peroxidase in hemolysis product, platelets and serum of 23 patients with rheumatoid polyarthritis and 11 healthy subjects. The nature of the treatment enables to divide the 23 patients into 3 groups: group I (8 cases): no treatment; Group II (7 cases): steroid therapy alone; group III (8 cases): basic treatment associated (3 cases) or not (5 cases) to steroid therapy. Statistical analysis shows no significant difference, whatever the environment and the treatment contemplated. The significance of these results is discussed and compared with literature data concerning only enzymatic activities and not the blood levels as in the present study.

[Prognostic and therapeutic significance of bone marrow biopsy in multiple myeloma. Analysis of 31 stage II A and III A patients]

The prognostic value of bone marrow biopsy was established in 31 patients suffering from stage IIA and IIIA myeloma (Durie and Salmon classification). Data obtained from quantitative marrow cytology permit to differentiate 3 sub-groups of cells: plasmocytes, plasmoblasts, plasmocytes/plasmoblasts of which the incidence on the prognosis and the response to treatment was studied. There is a correlation between the response to MP and the nature of various cells populations and, on the other hand, the type of infiltration. A sub-group of patients, resisting to MP, was identified: diffuse plasmoblastic myelomas of poor prognosis. Induction poly-chemotherapy seems far superior over the MP combination, which was always a controverted issue.

[Contribution of synovial biopsy in unclassified arthropathies]

The authors report a retrospective study of the diagnostic usefulness of synovial biopsy (SB) in 80 cases of unspecified forms of joint disease. SB was able to indicate the diagnosis in 23 (28.7%) of these patients. These 23 cases included 4 of the 15 cases (26.6%) of acute monoarticular arthritis, 5 (31.2%) of the 16 cases of acute oligopolyarthritis. In 6 cases (7.5%) SB was also responsible for the elimination of an initial diagnosis of septic arthritis. Overall, therefore, SB contributed to establishing a diagnosis and guiding therapy in 20 (36.2%) patients. Despite these rather low percentages, SB appears to be an essential examination, particularly in monoarticular arthritis, for the confirmation or exclusion of the diagnosis of conditions which present specific histologic signs and which require appropriate treatment.

[Glomerular nephropathies in untreated rheumatoid arthritis. Review of the literature apropos of 2 cases]

Two cases of classical rheumatoid arthritis complicated by the development of a glomerulopathy independently of drug treatment are presented. Renal biopsy showed membranous glomerulonephritis in one case and fusion of foot processes in the second. The literature is reviewed and the possible relationships between rheumatoid arthritis and these glomerulopathies are discussed. The authors conclude to the absence of causal relationship between these two diseases.

[Involvement of the cervical spine in chronic juvenile arthritis. 29 cases followed for more than 5 years]

Analysis of cervical spine involvement is based on data from 29 cases of juvenile chronic arthritis (JCA), (8 systemic and 21 polyarticular forms). Follow-up is a least 5 years and exceeds 10 years in 17 cases. Among these 29 patients, 14 experienced cervical pain. One patient had Arnold neuralgia. No other neurologic complications were recorded. 14 of the 29 patients exhibited one or more roentgenological changes (3 of the 8 systemic patients and 11 of the 21 polyarticular patients). Of these, 4 never had any corresponding clinical symptoms. A chronologic correlation between onset of clinical and radiological signs was clearly established in only three cases. Among roentgenologic features, loss of physiologic lordosis was recorded in four patients. This finding was always associated with other radiologic changes. Seven patients had involvement of the posterior spine: blurred articular outlines and erosion of posterior epiphyses in one patient, fusion of neural arch joints involving C2-C3 in two patients and C2-C3 and C3-C4 in two others, and extensive fusion from C2 to C7 in two cases. Changes in the anterior spine were always accompanied with posterior lesions at the same level. Atlanto-axial or atlanto-occipital involvement was found in 9 of our 29 patients. Seven had forward slipping of C1 over C2. No instances of vertebral slipping below C1-C2 or of vertebral collapse were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)