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Hadouiri N, Fournel I, Thauvin-Robinet C, Jacquin-Piques A, Ornetti P, Gueugnon M. Walking test outcomes in adults with genetic neuromuscular diseases: a systematic literature review of their measurement properties. Eur J Phys Rehabil Med 2024; 60:257-269. [PMID: 38300152 PMCID: PMC11114158 DOI: 10.23736/s1973-9087.24.08095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/11/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION Neuromuscular diseases (NMDs) include a large group of heterogeneous diseases. NMDs frequently involve gait disorders, which affect quality of life. Several walking tests and tools have been described in the literature, but there is no consensus regarding the use of walking tests and tools in NMDs or of their measurement properties for walking outcomes. The aim of this review is to present an overview of walking tests, including their measurement properties when used in adults with inherited or genetic NMDs. The aim is to help clinicians and researchers choose the most appropriate test for their objective. EVIDENCE ACQUISITION A systematic review was conducted after consulting MEDLINE (via PubMed), EMBASE, Science direct, Google Scholar and Cochrane Central Register of Controlled Trials databases for published studies in which walking outcome measurement properties were assessed. The validity, reliability, measurement error and responsiveness properties were evaluated in terms of statistical methods and methodological design qualities using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. EVIDENCE SYNTHESIS We included 46 studies in NMDs. These studies included 15 different walking tests and a wide variety of walking outcomes, assessed with six types of walking tools. Overall, the 6MWT was the most studied test in terms of measurement properties. The methodological design and statistical methods of most studies evaluating construct validity, reliability and measurement error were "very good." The majority of outcome measurements were valid and reliable. However, studies on responsiveness as minimal important difference or minimal important change were lacking or were found to have inadequate methodological and statistical methods according to the COSMIN guidelines. CONCLUSIONS Most walking outcomes were found to be valid and reliable in NMDs. However, in view of the growing number of clinical trials, further studies are needed to clarify additional measurement properties.
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Affiliation(s)
- Nawale Hadouiri
- Department of Physical Medicine and Rehabilitation, Dijon-Bourgogne University Hospital, Dijon, France -
- UMR-Inserm 1231, Génétique des Anomalies du Développement (GAD), Bourgogne Franche-Comté University, Dijon, France -
- INSERM, CIC 1432, Clinical Investigation Center, Plurithematic Module, Technological Investigation Platform, Dijon-Bourgogne University Hospital, Dijon, France -
| | - Isabelle Fournel
- Clinical Investigation Center, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Christel Thauvin-Robinet
- UMR-Inserm 1231, Génétique des Anomalies du Développement (GAD), Bourgogne Franche-Comté University, Dijon, France
- Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (TRANSLAD), CHU Dijon Bourgogne, Dijon, France
- Centre de Référence Maladies Rares "Maladies neurogénétiques", CHU Dijon Bourgogne, Dijon, France
| | - Agnès Jacquin-Piques
- Centre de Compétences Maladies Rares "Maladies neuromusculaires", Department of Neurology, Dijon University Hospital, Dijon, France
| | - Paul Ornetti
- Department of Rheumatology, Dijon-Bourgogne University Hospital, Dijon, France
- INSERM, UMR1093-CAPS, Bourgogne Franche-Comté University, Dijon, France
| | - Mathieu Gueugnon
- INSERM, CIC 1432, Clinical Investigation Center, Plurithematic Module, Technological Investigation Platform, Dijon-Bourgogne University Hospital, Dijon, France
- INSERM, UMR1093-CAPS, Bourgogne Franche-Comté University, Dijon, France
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Julliand S, Papaxanthis C, Delphin C, Mock A, Raumel MA, Gueugnon M, Ornetti P, Laroche D. IMPROVE study protocol, investigating post-stroke local muscle vibrations to promote cerebral plasticity and functional recovery: a single-blind randomised controlled trial. BMJ Open 2024; 14:e079918. [PMID: 38490651 PMCID: PMC10946362 DOI: 10.1136/bmjopen-2023-079918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/27/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Spasticity is a frequent disabling consequence following a stroke. Local muscle vibrations (LMVs) have been proposed as a treatment to address this problem. However, little is known about their clinical and neurophysiological impacts when used repeatedly during the subacute phase post-stroke. This project aims to evaluate the effects of a 6-week LMV protocol on the paretic limb on spasticity development in a post-stroke subacute population. METHODS AND ANALYSIS This is an interventional, controlled, randomised, single-blind (patient) trial. 100 participants over 18 years old will be recruited, within 6 weeks following a first stroke with hemiparesis or hemiplegia. All participants will receive a conventional rehabilitation programme, plus 18 sessions of LMV (ie, continuously for 30 min) on relaxed wrist and elbow flexors: either (1) at 80 Hz for the interventional group or (2) at 40 Hz plus a foam band between the skin and the device for the control group.Participants will be evaluated at baseline, at 3 weeks and 6 weeks, and at 6 months after the end of the intervention. Spasticity will be measured by the modified Ashworth scale and with an isokinetic dynamometer. Sensorimotor function will be assessed with the Fugl-Meyer assessment of the upper extremity. Corticospinal and spinal excitabilities will be measured each time. ETHICS AND DISSEMINATION This study was recorded in a clinical trial and obtained approval from the institutional review board (Comité de protection des personnes Ile de France IV, 2021-A03219-32). All participants will be required to provide informed consent. The results of this trial will be published in peer-reviewed journals to disseminate information to clinicians and impact their practice for an improved patient's care. TRIAL REGISTRATION NUMBER Clinical Trial: NCT05315726 DATASET: EUDRAct.
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Affiliation(s)
- Sophie Julliand
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
- INSERM U1093, Dijon, France
| | | | - Corentin Delphin
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
| | - Anne Mock
- Physical Medicine and Rehabilitation, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
| | - Marc-Antoine Raumel
- Physical Medicine and Rehabilitation, Hospital Centre Chalon-sur-Saône, Chalon-sur-Saône, France
| | - Mathieu Gueugnon
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
- INSERM U1093, Dijon, France
| | - Paul Ornetti
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
- INSERM U1093, Dijon, France
| | - Davy Laroche
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
- INSERM U1093, Dijon, France
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Chapon R, Alixant P, Laroche D, Ornetti P, Beaurain J, le Van T, Berhouma M, Ricolfi L. Influence of Posture on Gait Parameters in Severe Symptomatic Lumbar Stenosis Before and After Decompression Surgery. World Neurosurg 2024; 183:e109-e115. [PMID: 38030072 DOI: 10.1016/j.wneu.2023.11.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND We searched to quantify the influence of sagittal vertical axis (SVA) on the improvement of spatiotemporal gait parameters using a gait motion analysis (GMA) before and after decompression surgery in patients suffering from lumbar spinal stenosis (LSS). METHODS Thirty-nine patients with severe LisSS planned for lumbar decompression underwent a full-body biplanar radiographs (EOS) to quantify the SVA and have benefited from a 3-dimensional GMA 1 month before surgery (M0) and 6 month (M6) after surgery. The first step of this study was to confirm the validation of 3-dimensional sagittal vertical axis (3D SVA) for posture analysis. An analysis of modification of the 3D SVA and spatiotemporal gait parameters was then carried out in order to identify any correlation. RESULTS Decompression surgery did not significantly improve 3D SVA between M0 and M6 (respectively 49.1 [50.3] vs. 49.84 [19.02], P = 0.42). Concerning spatiotemporal parameters, we found significant difference for all parameters between M0 and M6. A strong correlation (R2 > 0.65) between static SVA (EOS) and 3D SVA was demonstrated using a statistical regression equation. There was also a statistically significant correlation between SVA (static and 3-dimension) and improvement in spatiotemporal gait parameters after decompression surgery. CONCLUSIONS This study analyses the relationship between postural change (SVA) and improvement in gait parameters measured during GMA before and after decompression surgery for LSS. This specific analysis of gait parameters may represent a prognostic assessment tool for the recovery of patients undergoing surgery for a LSS.
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Affiliation(s)
- Renan Chapon
- Department of Neurosurgery, University Hospital of Dijon Burgundy, Dijon, France
| | - Philibert Alixant
- Department of Neurosurgery, University Hospital of Dijon Burgundy, Dijon, France.
| | - Davy Laroche
- CIC INSERM 1432, Technological Investigation Platform, University Hospital of Dijon Burgundy, University of Burgundy, Dijon, France
| | - Paul Ornetti
- CIC INSERM 1432, Technological Investigation Platform, University Hospital of Dijon Burgundy, University of Burgundy, Dijon, France; Department of Rheumatology, University Hospital of Dijon Burgundy, Dijon, France
| | - Jacques Beaurain
- Department of Neurosurgery, University Hospital of Dijon Burgundy, Dijon, France
| | - Tuan le Van
- Department of Neurosurgery, University Hospital of Dijon Burgundy, Dijon, France
| | - Moncef Berhouma
- Department of Neurosurgery, University Hospital of Dijon Burgundy, Dijon, France; Functional and Molecular Imaging Team (CNRS 6302 - ICMUB), Molecular Chemistry Institute, University of Burgundy, Dijon, France
| | - Louis Ricolfi
- Department of Orthopaedic surgery, University Hospital of Dijon Burgundy, Dijon, France
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Herrmann S, Laboz M, Ornetti P. Uncommon acrometastasis mimicking dactylitis. Joint Bone Spine 2024; 91:105638. [PMID: 37734441 DOI: 10.1016/j.jbspin.2023.105638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Sarah Herrmann
- Department of Rheumatology, University Hospital, Dijon, France
| | - Marion Laboz
- Department of Rheumatology, University Hospital, Dijon, France
| | - Paul Ornetti
- Department of Rheumatology, University Hospital, Dijon, France; Plurithematic Module, Technological Investigation Platform, Inserm 1432, Dijon, France; Inserm UMR1093-CAPS, University of Burgundy, UFR STAPS, Dijon, France.
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Fakih O, Ramon A, Chouk M, Prati C, Ornetti P, Wendling D, Verhoeven F. Comparison of sacroiliac CT findings in patients with and without psoriatic arthritis: results of the CASIPSA Study. Rheumatology (Oxford) 2023; 62:e313-e314. [PMID: 37252815 DOI: 10.1093/rheumatology/kead258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/01/2023] Open
Affiliation(s)
- Olivier Fakih
- Service de Rhumatologie, CHU de Besançon, Besançon Cedex, France
| | - André Ramon
- Service de Rhumatologie, CHU de Dijon, Dijon Cedex, France
| | - Mickaël Chouk
- Service de Rhumatologie, CHU de Besançon, Besançon Cedex, France
| | - Clément Prati
- Service de Rhumatologie, CHU de Besançon, Besançon Cedex, France
- EA 4267 "PEPITE", UFR Santé, Franche-Comté University, Besançon Cedex, France
| | - Paul Ornetti
- Service de Rhumatologie, CHU de Dijon, Dijon Cedex, France
| | - Daniel Wendling
- Service de Rhumatologie, CHU de Besançon, Besançon Cedex, France
- EA 4266 "EPILAB", UFR Santé, Franche-Comté University, Besançon Cedex, France
| | - Frank Verhoeven
- Service de Rhumatologie, CHU de Besançon, Besançon Cedex, France
- EA 4267 "PEPITE", UFR Santé, Franche-Comté University, Besançon Cedex, France
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Fakih O, Ramon A, Chouk M, Prati C, Ornetti P, Wendling D, Verhoeven F. Comparison of sacroiliac CT findings in patients with and without ankylosing spondylitis aged over 50 years. Sci Rep 2023; 13:17901. [PMID: 37863967 PMCID: PMC10589274 DOI: 10.1038/s41598-023-45082-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
Diagnosis of axial spondyloarthritis (axSpA) is nowadays commonly made with the help of pelvic radiography or magnetic resonance imaging (MRI). However, there is an important inter-observer variability in radiography, and MRI is subject to possible false positives and is not the best modality for studying structural lesions. Conversely, pelvic computed tomography (CT) has excellent specificity and appears to be more effective than radiography for the diagnosis of ankylosing spondylitis (AS). However, its findings in patients over 50 years of age have not yet been studied. The objectives of this study were to describe the CT characteristics of sacro-iliac joints (SIJ) and the presence of intra-articular gas in patients with AS aged over 50 years and to compare them with controls of the same age and sex. This two-center, cross-sectional, observational study was performed using the medical records of the rheumatology departments of two University Hospitals. We included patients with a clinical diagnosis of axSpA, who had both definite radiographic sacroiliitis according to the modified New York criteria and met the ASAS 2009 criteria for axSpA (that is, AS), and who had undergone any CT scan including the whole SIJ. Each patient was matched for age and sex to a control randomly selected on the Picture Archiving and Communication System (PACS), symptomatic or asymptomatic, and without spondyloarthritis. For each individual, CT scans were interpreted blindly by two independent rheumatologists and scored for joint space narrowing (JSN), erosions, sclerosis, intra-articular gas, and diffuse idiopathic skeletal hyperostosis (DISH). Ninety patients and 90 controls were included in the study. The rates of positive JSN, erosion, and sclerosis scores were higher in the AS group (91% vs. 21%, p < 0.0001; 31% vs. 2%, p < 0.0001; 27% vs. 13%, p = 0.03, respectively), but the rates of intra-articular gas and DISH were higher in the control group (24% vs. 68%, p < 0.0001; 7% vs. 33%, p < 0.0001, respectively). 58% of patients had complete bilateral ankylosis. A total of 83 (92.2%) patients had a CT scan considered positive for AS, compared with only seven controls (7.8%). Sclerosis and erosions were predominantly on the anterosuperior part and iliac side of the joint in controls and were more diffuse in patients with AS. CT findings in patients with AS over 50 years of age are mostly represented by changes in the joint space; patients with AS have more erosions and sclerosis changes, but less intra-articular gas than controls.
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Affiliation(s)
- Olivier Fakih
- Service de rhumatologie, CHU de Besançon, 3 boulevard Fleming, 25030, Besançon Cedex, France.
| | - André Ramon
- Service de rhumatologie, CHU de Dijon, 14 rue Gaffarel, BP 77908, 21079, Dijon Cedex, France
| | - Mickaël Chouk
- Service de rhumatologie, CHU de Besançon, 3 boulevard Fleming, 25030, Besançon Cedex, France
| | - Clément Prati
- Service de rhumatologie, CHU de Besançon, 3 boulevard Fleming, 25030, Besançon Cedex, France
- EA 4267 "PEPITE", UFR Santé, Franche-Comté University, 19 rue Ambroise Paré, bâtiment S, 25030, Besançon Cedex, France
| | - Paul Ornetti
- Service de rhumatologie, CHU de Dijon, 14 rue Gaffarel, BP 77908, 21079, Dijon Cedex, France
| | - Daniel Wendling
- Service de rhumatologie, CHU de Besançon, 3 boulevard Fleming, 25030, Besançon Cedex, France
- EA 4266 "EPILAB", UFR Santé, Franche-Comté University, 19 rue Ambroise Paré, bâtiment S, 25030, Besançon Cedex, France
| | - Frank Verhoeven
- Service de rhumatologie, CHU de Besançon, 3 boulevard Fleming, 25030, Besançon Cedex, France
- EA 4267 "PEPITE", UFR Santé, Franche-Comté University, 19 rue Ambroise Paré, bâtiment S, 25030, Besançon Cedex, France
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Riglet L, Nicol F, Leonard A, Eby N, Claquesin L, Orliac B, Ornetti P, Laroche D, Gueugnon M. The Use of Embedded IMU Insoles to Assess Gait Parameters: A Validation and Test-Retest Reliability Study. Sensors (Basel) 2023; 23:8155. [PMID: 37836986 PMCID: PMC10575241 DOI: 10.3390/s23198155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023]
Abstract
Wireless wearable insoles are interesting tools to collect gait parameters during daily life activities. However, studies have to be performed specifically for each type of insoles on a big data set to validate the measurement in ecological situations. This study aims to assess the criterion validity and test-retest reliability of gait parameters from wearable insoles compared to motion capture system. Gait of 30 healthy participants was recorded using DSPro® insoles and a motion capture system during overground and treadmill walking at three different speeds. Criterion validity and test-retest reliability of spatio-temporal parameters were estimated with an intraclass correlation coefficient (ICC). For both systems, reliability was found higher than 0.70 for all variables (p < 0.001) except for minimum toe clearance (ICC < 0.50) with motion capture system during overground walking. Regardless of speed and condition of walking, Speed, Cadence, Stride Length, Stride Time and Stance Time variables were validated (ICC > 0.90; p < 0.001). During walking on treadmill, loading time was not validated during slow speed (ICC < 0.70). This study highlights good criterion validity and test-retest reliability of spatiotemporal gait parameters measurement using wearable insoles and opens a new possibility to improve care management of patients using clinical gait analysis in daily life activities.
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Affiliation(s)
- Louis Riglet
- CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, CIC 1432, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
| | | | | | | | - Lauranne Claquesin
- CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, CIC 1432, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
| | - Baptiste Orliac
- CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, CIC 1432, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
| | - Paul Ornetti
- CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, CIC 1432, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, 21000 Dijon, France
- Rheumatology Department, CHU Dijon-Bourgogne, 21000 Dijon, France
| | - Davy Laroche
- CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, CIC 1432, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, 21000 Dijon, France
| | - Mathieu Gueugnon
- CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, CIC 1432, Module Plurithématique, Plateforme d’Investigation Technologique, 21000 Dijon, France
- INSERM, UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, 21000 Dijon, France
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Patriat Q, Prigent FV, Aho S, Lenfant M, Ramon A, Loffroy R, Lambert A, Ornetti P. Diagnostic Value of an Additional Sequence (Large-Field Coronal Stir) in a Routine Lumbar Spine MR Imaging Protocol to Investigate Lumbar Radiculopathy. J Clin Med 2023; 12:6250. [PMID: 37834894 PMCID: PMC10573339 DOI: 10.3390/jcm12196250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE Lumbar radiculopathy mainly originates in the spine (lumbar disc herniation or spine osteoarthritis) but can sometimes be explained by extra-spinal nerve compression or confused with referred pain mimicking radiculopathy. Our main objective was to demonstrate the clinical benefit of the large-field coronal STIR (coroSTIR) sequence in the etiological assessment of lumbar radiculopathy with a duration of more than six weeks. MATERIALS AND METHODS Six hundred consecutive lumbar MRI scans performed using the same protocol were retrospectively reviewed. Two musculoskeletal radiologists independently assessed the coroSTIR sequence for the presence of extra-spinal anomalies (ESA) that could explain or contribute to the lumbar radiculopathy. The presence of an ESA was then correlated with sex, age, topography and lateralization of radiculopathy, history of vertebral surgery, as well as the presence of a spinal cause explaining the symptoms. Extra-spinal incidentalomas (ESI) with potential clinical impact visible only on the coroSTIR sequence were also systematically reported. RESULTS An extra-spinal cause was detected on the coroSTIR sequence in 68 cases (11.3%), mainly gluteal tendinobursitis (30.9%), congestive hip osteoarthritis (25%), degenerative sacroiliac arthropathy (14.7%), or inflammatory sacroilitis (7.3%). Their prevalence was significantly correlated in multivariate regression with age (58 years vs. 53 years, p = 0.01), but not with the type of radiating pain (sciatica or cruralgia). The presence of ESI was also frequent (70 cases, 11.7%), including some potentially severe diagnoses (38% of tumor or pseudo-tumor mass requiring further assessment or monitoring). CONCLUSIONS Considering its acceptable acquisition time, the detection of a significant number of potentially symptom-related extra-spinal anomalies, and the discovery of a non-negligible number of extra-spinal incidentalomas with potential clinical impact, the coronal STIR should be performed systematically in routine MRI for lumbar radiculopathy.
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Affiliation(s)
- Quentin Patriat
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; (Q.P.); (F.-V.P.); (R.L.)
| | - François-Victor Prigent
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; (Q.P.); (F.-V.P.); (R.L.)
| | - Serge Aho
- Department of Epidemiology and Biostatistics, François-Mitterrand University Hospital, 21079 Dijon, France;
| | - Marc Lenfant
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 21079 Dijon, France;
| | - André Ramon
- Department of Rheumatology, François-Mitterrand University Hospital, 21079 Dijon, France;
- INSERM, EFS Bourgogne Franche-Comté, UMR 1098, RIGHT Graft-Host-Tumor Interactions/Cellular and Genetic Engineering, Bourgogne Franche-Comté University, 21079 Dijon, France
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; (Q.P.); (F.-V.P.); (R.L.)
- ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 21079 Dijon, France
| | - Aurelien Lambert
- Department of Radiology, IM2P, Clinique Valmy, 21079 Dijon, France;
| | - Paul Ornetti
- Department of Rheumatology, François-Mitterrand University Hospital, 21079 Dijon, France;
- INSERM UMR1093-CAPS, Bourgogne Franche-Comté University, UFR STAPS, 21079 Dijon, France
- INSERM, Bourgogne Franche-Comté University, CIC 1432, Module Plurithématique, Plateforme d’Investigation Technologique, François-Mitterrand University Hospital, 21079 Dijon, France
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Tchurukdichian A, Delgove A, Essid L, Moris V, di Summa PG, Camuzard O, Ornetti P, Zwetyenga N, Guillier D. Time to return to work after total trapeziometacarpal prosthesis. Hand Surg Rehabil 2023:S2468-1229(23)00116-0. [PMID: 37356569 DOI: 10.1016/j.hansur.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES This study assessed return to work and prosthesis survival after trapeziometacarpal prosthesis surgery. MATERIAL AND METHODS A multicenter retrospective study was carried out on patients operated on between 2002 and 2020. All working patients who had undergone trapeziometacarpal prosthesis surgery were included. Return to work was defined as resuming the same full-time position. Postoperative events and their specific treatment and failure to return to work were reported. RESULTS 240 prostheses in 211 patients were included. The complications rate was 7.5%, with 97% prosthesis survival. 94.3% of patients returned to work, at a mean 48 days (range, 29-210 days; SD, 22.7 days), with no significant difference according to age. Twelve patients did not return to work, half of whom because of prosthetic complications. CONCLUSION Trapeziometacarpal arthroplasty enables most patients to return to work within 6 weeks. In this series, the prosthetic survival rate was 97%.
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Affiliation(s)
- A Tchurukdichian
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France; Chirurgie de la main, Cliniques de Valmy et de Drevon, 1 bis cours Général de Gaulle F-21000 Dijon, France
| | - A Delgove
- Service de chirurgie plastique, reconstructrice et esthétique, CHU de Bordeaux, place Amélie Raba Léon, 33000 Bordeaux, France
| | - L Essid
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France
| | - V Moris
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France
| | - P G di Summa
- Department of Plastic and Hand Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Rue de Bugnon 46, 1011 Lausanne, Switzerland
| | - O Camuzard
- Department of Plastic and Reconstructive Surgery, Hôpital Pasteur 2, CHU de Nice, Université Côte d'Azur, Nice, France
| | - P Ornetti
- Department of Rhumatology - Dijon University Hospital, Boulevard de Lattre de Tassigny, F-21000, Dijon, France
| | - N Zwetyenga
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France
| | - D Guillier
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France.
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Courtine M, Bourredjem A, Gouteron A, Fournel I, Bartolone P, Baulot E, Ornetti P, Martz P. Functional recovery after total hip/knee replacement in obese people: A systematic review. Ann Phys Rehabil Med 2023; 66:101710. [PMID: 36459889 DOI: 10.1016/j.rehab.2022.101710] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 08/04/2022] [Accepted: 09/24/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE Several studies have investigated the influence of body mass index (BMI) on functional gain after total hip replacement (THR) or total knee replacement (TKR) in osteoarthritis, with contradictory results. This systematic literature review was conducted to ascertain whether obesity affects functional recovery after THR or TKR in the short (<1 year), medium (<3 years) and long term (>3 years). METHODS The study was registered with PROSPERO and conducted according to the PRISMA guidelines. A systematic literature search was conducted across Medline and EMBASE databases for articles published between 1980 and 2020 that investigated patient-reported measures of functional recovery after THR and TKR in participants with osteoarthritis and obesity (defined as BMI ≥30 kg/m2). RESULTS Twenty-six articles reporting on 68,840 persons (34,955 for THR and 33,885 for TKR) were included in the final analysis: 5 case-control studies, 21 cohort studies (9 for THR only, 10 for TKR only and 2 for both). The average minimum follow-up was 36.4 months, ranging from 6 weeks to 10 years. Most studies found significantly lower pre-operative patient-reported functional scores for participants with obesity. After THR, there was a small difference in functional recovery in favor of those without obesity in the short term (<6 months), but the difference remained below the minimal clinically important difference (MCID) threshold and disappeared in the medium and long term. After TKR, functional recovery was better for those with obesity than those without in the first year, similar until the third year, and then decreased thereafter. CONCLUSIONS Although there is a paucity of high-quality evidence, our findings show substantial functional gains in people with obesity after total joint replacement. Functional recovery after THR or TKR does not significantly differ, or only slightly differs, between those with and without obesity, and the difference in functional gain is not clinically important. PROSPERO NUMBER CRD42018112919.
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Affiliation(s)
- Matthieu Courtine
- Dijon university hospital, Department of Orthopaedic surgery, CHU Dijon-Bourgogne, France
| | | | - Anaïs Gouteron
- INSERM UMR1093-CAPS, Université de Bourgogne, UFR STAPS, Dijon, France; Dijon university hospital, Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France
| | - Isabelle Fournel
- INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
| | | | - Emmanuel Baulot
- Dijon university hospital, Department of Orthopaedic surgery, CHU Dijon-Bourgogne, France; INSERM UMR1093-CAPS, Université de Bourgogne, UFR STAPS, Dijon, France
| | - Paul Ornetti
- INSERM UMR1093-CAPS, Université de Bourgogne, UFR STAPS, Dijon, France; Dijon university hospital, Department of Rheumatology, CHU Dijon-Bourgogne, Dijon, France; INSERM, Université de Bourgogne, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.
| | - Pierre Martz
- Dijon university hospital, Department of Orthopaedic surgery, CHU Dijon-Bourgogne, France; INSERM UMR1093-CAPS, Université de Bourgogne, UFR STAPS, Dijon, France; INSERM, Université de Bourgogne, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France
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11
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Gouteron A, Laroche D, Beaurain J, Ksiazek E, Fournel I, Bohm A, Ornetti P, Casillas JM, Armand S, Gueugnon M. Effect of decompression surgery for lumbar spinal stenosis on aerobic capacities during a 6-min walk test: A preliminary cohort study. Ann Phys Rehabil Med 2022; 66:101673. [PMID: 35489687 DOI: 10.1016/j.rehab.2022.101673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/13/2022] [Accepted: 04/16/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Anaïs Gouteron
- Department of Physical Medicine and Rehabilitation, Dijon-Bourgogne University Hospital, Dijon, France; INSERM U1093, Cognition Action et Plasticité Sensorimotrice, Université de Bourgogne Franche Comté, Dijon, France.
| | - Davy Laroche
- INSERM U1093, Cognition Action et Plasticité Sensorimotrice, Université de Bourgogne Franche Comté, Dijon, France; INSERM, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France
| | - Jacques Beaurain
- Neurosurgery department, Dijon-Bourgogne University Hospital, Dijon, France
| | - Elea Ksiazek
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | - Amélie Bohm
- Rheumatology department, Dijon-Bourgogne University Hospital, Dijon, France
| | - Paul Ornetti
- INSERM U1093, Cognition Action et Plasticité Sensorimotrice, Université de Bourgogne Franche Comté, Dijon, France; INSERM, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France; Rheumatology department, Dijon-Bourgogne University Hospital, Dijon, France
| | - Jean-Marie Casillas
- Department of Physical Medicine and Rehabilitation, Dijon-Bourgogne University Hospital, Dijon, France; INSERM U1093, Cognition Action et Plasticité Sensorimotrice, Université de Bourgogne Franche Comté, Dijon, France; INSERM, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Mathieu Gueugnon
- INSERM U1093, Cognition Action et Plasticité Sensorimotrice, Université de Bourgogne Franche Comté, Dijon, France; INSERM, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France
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12
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Bertaux A, Gueugnon M, Moissenet F, Orliac B, Martz P, Maillefert JF, Ornetti P, Laroche D. Gait analysis dataset of healthy volunteers and patients before and 6 months after total hip arthroplasty. Sci Data 2022; 9:399. [PMID: 35821499 PMCID: PMC9276684 DOI: 10.1038/s41597-022-01483-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/16/2022] [Indexed: 11/09/2022] Open
Abstract
Clinical gait analysis is a promising approach for quantifying gait deviations and assessing the impairments altering gait in patients with osteoarthritis. There is a lack of consensus on the identification of kinematic outcomes that could be used for the diagnosis and follow up in patients. The proposed dataset has been established on 80 asymptomatic participants and 106 patients with unilateral hip osteoarthritis before and 6 months after arthroplasty. All volunteers walked along a 6 meters straight line at their self-selected speed. Three dimensional trajectories of 35 reflective markers were simultaneously recorded and Plugin Gait Bones, angles, Center of Mass trajectories and ground reaction forces were computed. Gait video recordings, when available, anthropometric and demographic descriptions are also available. A minimum of 10 trials have been made available in the weka file format and C3D file to enhance the use of machine learning algorithms. We aim to share this dataset to facilitate the identification of new movement-related kinematic outcomes for improving the diagnosis and follow up in patients with hip OA.
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Affiliation(s)
- Aurélie Bertaux
- CIAD UMR 7533, Univ. Bourgogne Franche-Comté, UB, F-21000, Dijon, France
| | - Mathieu Gueugnon
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France.,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France
| | | | - Baptiste Orliac
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France
| | - Pierre Martz
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France.,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,Orthopaedics department, CHU Dijon-Bourgogne, 21000, Dijon, France
| | - Jean-Francis Maillefert
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France.,Rheumatology department, CHU Dijon-Bourgogne, 21000, Dijon, France
| | - Paul Ornetti
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France.,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,Rheumatology department, CHU Dijon-Bourgogne, 21000, Dijon, France
| | - Davy Laroche
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France. .,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France. .,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France.
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13
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Ramon A, Greigert H, Cladière C, Ciudad M, Ornetti P, Bonnotte B, Samson M. POS0494 ARTERIAL WALL DENDRITIC CELLS IN GIANT CELL ARTERITIS (GCA) AND POLYMYALGIA RHEUMATICA (PMR). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPolymyalgia rheumatica (PMR) is an inflammatory rheumatic disease (1) associated in 16 to 21% of cases with giant cell arteritis (GCA). The association of these two conditions raises the question of a pathophysiological continuum between PMR and GCA. An early study reported mature arterial wall dendritic cells (DC) in patients with GCA or PMR leading, during GCA, to CD4+ T cell recruitment and the development of vasculitis (2). However, these data have never been confirmed in other studies. There are 3 main types of DC: plasmacytoid DC (expressing CD123), conventional DC (cDC) expressing CD141 (cDC1) or CD1c (cDC2) and monocyte-derived DC (mo-DC) expressing CD14.ObjectivesThe aim of this study was to describe the arterial wall infiltrating DCs, their phenotype and maturation state, during PMR and GCA.MethodsUsing temporal artery biopsies (TAB) from patients with PMR, GCA and healthy controls, the level of expression of CD11c, CD83, CCR7, CCR6, CD1c, CCL18, CCL19, CCL20, CCL21, GM-CSF, CD3, CD68 genes was assessed by RT-PCR. Expression of markers of DC lineage (CD209), DC maturation state (CD83 and CCR7) and DC origin (CD14, CD68, CD1c, CD141) were studied by confocal microscopy.ResultsFourty-one patients were included (14 GCA, 16 PMR, 11 controls). Within the arterial wall, DCs were identified in GCA patients, with a mature DC phenotype (CD209+CD83+CCR7+). DC were present in all three layers of the arterial wall and also expressed CD14 and often CD68 but neither CD1c nor CD141, which could be explained by a monocytic/macrophage origin. TAB from GCA patients were characterized by a high level of expression of CD83, CCR7, CCR6, CCL18, CCL19, CCL20, CD11c, GM-CSF, CD3 and CD68 gene. This expression was significantly higher (p<0.05) compared to the control and PMR groups.Confocal microscopy analyses of arteries from the PMR and controls did not detect the presence of DCs into the arterial wall. In addition, level of expression of CD83, CCR7, CCL18, CCL19, CCL21 and CD68 genes in temporal arteries was comparable between PMR and healthy controls.ConclusionThis work confirms the presence of mature CD209+CD83+CCR7+ DCs within the arterial wall in GCA. The phenotype of these DCs mainly fits with DC of monocytic origin (mo-DCs). However, both by RT-PCR and confocal microscopy, we did not identify DCs in the arterial wall of PMR patients. This discrepancy with previous work (3) could be explained by a better diagnosis of GCA in PMR patients since the development of imaging techniques.References[1]Weyand CM, Goronzy JJ. Giant-Cell Arteritis and Polymyalgia Rheumatica. N Engl J Med. 2014;371:50-7.[2]Samson M, Corbera-Bellalta M, Audia S, Planas-Rigol E, Martin L, Cid MC, et al. Recent advances in our understanding of giant cell arteritis pathogenesis. Autoimmun Rev. 2017;16:833-44.[3]Ma-Krupa W, Jeon M-S, Spoerl S, Tedder TF, Goronzy JJ, Weyand CM. Activation of Arterial Wall Dendritic Cells and Breakdown of Self-tolerance in Giant Cell Arteritis. J Exp Med. 2004;199:173-83.Disclosure of InterestsNone declared.
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Fakih O, Ramon A, Prati C, Ornetti P, Wendling D, Verhoeven F. AB1348 COMPARISON OF SACROILIAC CT FINDINGS IN PATIENTS WITH AND WITHOUT PSORIATIC ARTHRITIS: RESULTS OF THE CASIPSA STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPsoriatic arthritis (PsA) is an inflammatory arthritis associated with various rheumatological manifestations, such as arthritis or enthesitis, predominantly in the peripheral skeleton. However, the axial skeleton may be affected, as shown clinically or by conventional radiographs in up to 70% of patients with peripheral involvement. While there are studies comparing joint damage on standard radiography between patients with PsA and patients with ankylosing spondylitis [1], to our knowledge, no study has specifically evaluated the extent of structural lesions of the sacroiliac joints (SIJs) on computed tomography (CT) in patients with PsA compared with healthy controls.ObjectivesTo describe SIJ CT characteristics in patients with PsA and compare them with those of age- and sex-matched controls.MethodsAn observational, retrospective study was performed using medical records from Besançon and Dijon University Hospital’s rheumatology departments, which were screened to identify patients with PsA, according to the CASPAR criteria. A search was then carried out for patients in the hospitals’ imaging archiving system to identify those who had undergone a CT which included the SIJs in their entirety. Non-inclusion criteria were the existence of pelvic bone lesions and a history of pelvic radiotherapy. Each patient was then matched with a control of the same age and sex, recruited through the hospital’s imaging archiving system.For each individual, CT was interpreted by two independent readers using a score previously used by Diekhoff et al. [2], dividing each SIJ into 12 regions, for each of which joint space narrowing (JSN), erosions, and sclerosis are assessed. For this study, we also observed the existence of intra-articular gas and diffuse idiopathic skeletal hyperostosis (DISH) lesions for each region. Quantitative variables were compared using Student’s t-test. Qualitative variables were compared using the Chi-2 test.Results48 patients and 48 controls were included. Mean (SD) age was 54.76 ± 12.91 in the PsA group and 54.74 + 12.87 in the control group. 26 (54.18%) were male in both groups. In PsA patients, mean (SD) disease duration was 22.87 ± 14.95 years, 10 (43.48 %) were HLA-B27 positive, and 1 (2.86%) had a bamboo spine. CT findings are described in Table 1. The only lesion found significantly more frequently in PsA patients was erosion, which appeared to be preferentially located on the anterior and middle regions of the SIJs (Figure 1). A positive CT scan (significant joint space narrowing, erosion and/or sclerosis) was found in 15 (32.61%) of the patients with peripheral involvement and 6 (30.00%) of the patients with axial involvement.Table 1.Sacro-iliac CT findings using a score modified from Diekhoff et al.FindingPsA PatientsControlsp-valueMean (SD) total score (range 0-264)26.37 ± 29.1214.47 ± 10.850.01Global positivity, n (%)16 (33.33 %)10 (20.83 %)0.17Bilateral ankylosis, n (%)5 (10.42 %)0 (0.00 %)0.02Positive joint space score, n (%)15 (31.25 %)10 (20.83 %)0.25Positive erosion score, n (%)9 (18.75 %)1 (2.08 %)0.008Significant sclerosis, n (%)11 (22.92 %)12 (25.00 %)0.81Intra-articular gas, n (%)29 (60.42 %)35 (72.92 %)0.19DISH, n (%)9 (18.75%)11 (22.92 %)0.62Figure 1.Mean scores by region on anterior, middle, and posterior slices (JS: joint space, Ero: erosions, Scl: sclerosis) in PsA patients (A) and controls (B).ConclusionThe CT characteristics of SIJs from patients with PsA were similar to those of age- and sex-matched controls, but with a higher prevalence of erosions. Structural lesions of the SIJs were found in nearly one PsA patient out of three.References[1]Jadon DR, Sengupta R, Nightingale A, et al. Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. Ann Rheum Dis. 2017;76:701–7.[2]Diekhoff T, Hermann K-GA, Greese J, et al. Comparison of MRI with radiography for detecting structural lesions of the sacroiliac joint using CT as standard of reference: results from the SIMACT study. Ann Rheum Dis. 2017;76(9):1502-1508.Disclosure of InterestsNone declared
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Staszewski E, Vaillant A, Piroth C, Patte A, Arbault A, Vazzano C, Ramon A, Ornetti P. AB1558-HPR TELERHEUMATOLOGY WITH PRIMARY CARE CENTERS: FEEDBACK FROM AN EXPERIMENTAL TELEMEDICINE PROJECT IN BURGUNDY (2019-2021). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundTelemedicine could be an innovative and sustainable response for rheumatologic advice in areas with low medical density. Improving coordination of investigations, access to allied health members and dedicated telehealth platform may improve the management of many rheumatologic patients.MethodsThis French TeleRheumatology project with multidisciplinary primary care centres was set up in 2019, specifically targeting the Burgundy region in Eastern France and was financed by the Regional Health Agency. Four rheumatologists from the Dijon University Hospital took turns to respond to the various requests for telemedicine (teleconsultation, teleexpertises) on a dedicated digital platform integrating a medical imaging viewer. In addition to the activity (number and type of procedures performed) and the distances avoided for the patient for rheumatology consultation, feasibility of this colaborative digital project was assessed on the basis of a participant satisfaction questionnaire (rheumatologists, general practitioners and patients).ResultsFrom October 2019 to january 2022, this TeleRheumatology project allowed the progressive integration of 23 primary care centres despite the concomitant COVID-19 crisis which slowed down the deployment. 212 procedures were performed (96% teleexpertises): 76% for mechanical disorders (spine 31%, osteoporosis 19%, osteoarthritis 15%), 18% for inflammatory rheumatism, 53% advice for diagnosis, 41% for management and/or therapy, 89% with imaging (X-Rays, CT- Scan, MRI) to be reviewed. The average response time was 16 hours and the average number of round-trip kilometers avoided was 216. Only 15% of the rheumatologic advices led to a face-to-face consultation or hospitalization at the University Rheumatology Department and 6% to other specialists. 97% of the patients would like to use this Telerheumatology program again (Satisfaction score: 9.1/10). 100% of the expert rheumatologists (satisfaction score 9.25/10) and the general practitioners (satisfaction score: 9.0/10) wanted to continue this digital health partnership in their daily practice.ConclusionDespite the inherent limitations of telemedicine (absence of clinical examination, technical barriers of interoperability, etc.), this french innovative TeleRheumatology project with primary care centres has shown encouraging results in terms of acceptability and satisfaction thanks to the coordination of the Regional Health agency and physicians’ motivations. Telerexpertise seems to be the preferred modality given its better practical feasibility. Approval and acceptance are increasing in the Rheumatology community because telemedicine appears to be an effective tool for improving health care access as demonstrated by its rapid expansion, especially during the COVID-19 pandemic.References[1]Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study.Muehlensiepen F, Knitza J, Marquardt W, May S, Krusche M, Hueber A, Schwarz J, Vuillerme N, Heinze M, Welcker M. Int J Environ Res Public Health. 2021 Dec 13;18(24):13127.Disclosure of InterestsNone declared
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Ramon A, Greigert H, Ornetti P, Bonnotte B, Samson M. Mimickers of Large Vessel Giant Cell Arteritis. J Clin Med 2022; 11:jcm11030495. [PMID: 35159949 PMCID: PMC8837104 DOI: 10.3390/jcm11030495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 01/27/2023] Open
Abstract
Giant cell arteritis (GCA) is a large-vessel granulomatous vasculitis occurring in patients over 50-year-old. Diagnosis can be challenging because there is no specific biological test or other diagnoses to consider. Two main phenotypes of GCA are distinguished and can be associated. First, cranial GCA, whose diagnosis is usually confirmed by the evidence of a non-necrotizing granulomatous panarteritis on temporal artery biopsy. Second, large-vessel GCA, whose related symptoms are less specific (fever, asthenia, and weight loss) and for which other diagnoses must be implemented if there is neither cephalic GCA nor associated polymyalgia rheumatica (PMR) features chronic infection (tuberculosis, Coxiella burnetti), IgG4-related disease, Erdheim Chester disease, and other primary vasculitis (Behçet disease, relapsing polychondritis, or VEXAS syndrome). Herein, we propose a review of the main differential diagnoses to be considered regarding large vessel vasculitis.
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Affiliation(s)
- André Ramon
- Rheumatology Department, Dijon-Bourgogne University Hospital, 21000 Dijon, France;
- INSERM, EFS BFC, UMR 1098, RIGHT Graft-Host-Tumor Interactions/Cellular and Genetic Engineering, Bourgogne Franche-Comté University, 21000 Dijon, France; (H.G.); (B.B.); (M.S.)
- Correspondence:
| | - Hélène Greigert
- INSERM, EFS BFC, UMR 1098, RIGHT Graft-Host-Tumor Interactions/Cellular and Genetic Engineering, Bourgogne Franche-Comté University, 21000 Dijon, France; (H.G.); (B.B.); (M.S.)
- Internal Medicine and Clinical Immunology Department, Dijon-Bourgogne University Hospital, 21000 Dijon, France
- Vascular Medicine Department, Dijon-Bourgogne University Hospital, 21000 Dijon, France
| | - Paul Ornetti
- Rheumatology Department, Dijon-Bourgogne University Hospital, 21000 Dijon, France;
- INSERM, CIC 1432, Clinical Investigation Center, Plurithematic Module, Technological Investigation Platform, Dijon-Bourgogne University Hospital, 21000 Dijon, France
- INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport, 21000 Dijon, France
| | - Bernard Bonnotte
- INSERM, EFS BFC, UMR 1098, RIGHT Graft-Host-Tumor Interactions/Cellular and Genetic Engineering, Bourgogne Franche-Comté University, 21000 Dijon, France; (H.G.); (B.B.); (M.S.)
- Internal Medicine and Clinical Immunology Department, Dijon-Bourgogne University Hospital, 21000 Dijon, France
| | - Maxime Samson
- INSERM, EFS BFC, UMR 1098, RIGHT Graft-Host-Tumor Interactions/Cellular and Genetic Engineering, Bourgogne Franche-Comté University, 21000 Dijon, France; (H.G.); (B.B.); (M.S.)
- Internal Medicine and Clinical Immunology Department, Dijon-Bourgogne University Hospital, 21000 Dijon, France
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17
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Dubief B, Avril J, Pascart T, Schmitt M, Loffroy R, Maillefert JF, Ornetti P, Ramon A. Optimization of dual energy computed tomography post-processing to reduce lower limb artifacts in gout. Quant Imaging Med Surg 2022; 12:539-549. [PMID: 34993099 DOI: 10.21037/qims-21-321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/15/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND In gout, several types of dual-energy computed tomography (DECT) artifacts have been described (nail bed, skin, beam hardening, submillimeter and vascular artifacts), which can lead to overdiagnosis. The objective of this study was to determine the optimal DECT settings for post processing in order to reduce the frequency of some common artifacts in patients with suspected gout. METHODS Seventy-seven patients hospitalized for suspected gout (feet/ankles and/or knees) who received a DECT imaging were included (final diagnosis of 43 gout and 34 other rheumatic disorders). Different post-processing settings were evaluated using Syngovia software: nine settings (R1 to R9) were evaluated with a combination of different ratio (1.28, 1.36 and 1.55) and attenuation coefficient (120, 150, 170 HU). RESULTS Among the nine settings tested, the R2 setting (170 HU, ratio =1.28) significantly reduced the presence of knee and foot/ankle artifacts compared to the standard R1 setting (85% and 94% decrease in beam hardening and clumpy artifacts in the ankle and foot, respectively (P<0.001); a decrease of 71%, 60% and 88% respectively of meniscal beam hardening, beam hardening and submillimeter artifacts in the knee (P<0.001). Compared to standard settings, the use of R2 settings decreased sensitivity [0.79 (95% CI: 0.65, 0.88) versus 0.90 (95% CI: 0.78, 0.96)] and increased specificity [0.86 (95% CI: 0.71, 0.93) versus 0.63 (95% CI: 0.47, 0.77)] (P<0.001). Settings using an attenuation coefficient to 120 HU and/or a ratio to 1.55 were all associated with a significant increasing of artifacts, especially clumpy and beam hardening artifacts. CONCLUSIONS Applying a ratio of 1.28 and a minimum attenuation of 170 HU in DECT post-processing eliminates the majority of artifacts located in the lower limbs, particularly clumpy artifacts and beam hardening.
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Affiliation(s)
- Baptiste Dubief
- Rheumatology Department, Dijon-Bourgogne University Hospital, Dijon, France
| | - Julien Avril
- Diagnostic and Therapeutic Radiology Department, Dijon- Bourgogne University Hospital, Dijon, France
| | - Tristan Pascart
- Rheumatology Department, Lille Catholic Hospitals, University of Lille, Lomme, France.,EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, Lille, France
| | - Marie Schmitt
- Rheumatology Department, Dijon-Bourgogne University Hospital, Dijon, France
| | - Romaric Loffroy
- Diagnostic and Therapeutic Radiology Department, Dijon- Bourgogne University Hospital, Dijon, France
| | - Jean-Francis Maillefert
- Rheumatology Department, Dijon-Bourgogne University Hospital, Dijon, France.,INSERM UMR1093-CAPS, Université Bourgogne, UFR des Sciences du Sport, Dijon, France
| | - Paul Ornetti
- Rheumatology Department, Dijon-Bourgogne University Hospital, Dijon, France.,INSERM UMR1093-CAPS, Université Bourgogne, UFR des Sciences du Sport, Dijon, France.,CIC-P, Plurithematic Module, Technological Investigation Platform, Dijon-Burgundy University Hospital, Dijon, France
| | - André Ramon
- Rheumatology Department, Dijon-Bourgogne University Hospital, Dijon, France
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18
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Hadouiri N, Thomas Q, Darmency V, Dulieu V, De Rougemont MGM, Bruel AL, Duffourd Y, Lecoquierre F, Colomb B, Perez-Martin S, Ornetti P, Blanchard O, Sorlin A, Philippe C, Faivre L, Vitobello A, Thauvin-Robinet C. Homozygous TRAPPC11 truncating variant revealing segmental uniparental disomy of chromosome 4 as a cause of a recessive limb-girdle muscular dystrophy-18. Clin Genet 2021; 100:643-644. [PMID: 34435357 DOI: 10.1111/cge.14045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Nawale Hadouiri
- INSERM-Université Bourgogne, Dijon, France.,Pôle Rééducation-Réadaptation, Dijon, France
| | - Quentin Thomas
- INSERM-Université Bourgogne, Dijon, France.,Service de Neurologie, Dijon, France
| | | | | | | | - Ange-Line Bruel
- INSERM-Université Bourgogne, Dijon, France.,Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, Dijon, France
| | - Yannis Duffourd
- INSERM-Université Bourgogne, Dijon, France.,Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, Dijon, France
| | - François Lecoquierre
- INSERM-Université Bourgogne, Dijon, France.,Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, Dijon, France
| | | | | | - Paul Ornetti
- INSERM, Plateforme d'Investigation Technologique, Dijon, France.,Service de Rhumatologie, Dijon, France
| | | | - Arthur Sorlin
- INSERM-Université Bourgogne, Dijon, France.,Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Interrégion Est, Dijon, France
| | - Christophe Philippe
- INSERM-Université Bourgogne, Dijon, France.,Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, Dijon, France
| | - Laurence Faivre
- INSERM-Université Bourgogne, Dijon, France.,Centre de Référence Maladies Rares, Anomalies du Développement et Syndromes Malformatifs, Dijon, France
| | - Antonio Vitobello
- INSERM-Université Bourgogne, Dijon, France.,Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, Dijon, France
| | - Christel Thauvin-Robinet
- INSERM-Université Bourgogne, Dijon, France.,Unité Fonctionnelle Innovation en Diagnostic Génomique des Maladies Rares, Dijon, France.,Centre de Référence Maladies Rares, Déficiences Intellectuelles de Causes Rares, Dijon, France
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19
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Lamas V, Gueugnon M, Fournel I, Grelat M, Maillefert JF, Ornetti P, Martz P. Dynamic global sagittal alignment in patients with lumbar spinal stenosis: Analysis of the effects of decompression surgery on gait adaptations. Gait Posture 2021; 88:272-279. [PMID: 34144331 DOI: 10.1016/j.gaitpost.2021.05.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Lumbar spinal stenosis (LSS) leads patients to adapt their posture and walking parameters. Pelvic retroversion might be a compensation mechanism of pain. Pelvic and lower limbs compensations during gait are still not precisely understood, as well as the effect of a surgical decompression on them. These dynamic parameters can be studied through three-dimensional gait analysis. RESEARCH QUESTION Is the dynamic pelvic tilt modified after decompression surgery in LSS patients compared to asymptomatic subjects? MATERIAL AND METHODS 50 asymptomatic subjects (C-group) and 37 patients operated on for lumbar decompression underwent a three-dimensional gait analysis one month before (M0) and six months after (M6) the surgery. 3D gait analysis was performed and hip and knee flexion, trunk kinematics, walking speed, stride length and pelvic tilt during gait or dynamic pelvic tilt (dPT) were recorded. Health-related quality of life (HRQL) scores (Oswestry Disability Index (ODI) and Visual Analogic Scales (VAS)) and radiological assessment were performed preoperatively and postoperatively. RESULTS Mean values of maximum and minimum dPT in the LSS-group preoperatively were significantly higher compared to the C-group (respectively 10.9 (6.2)° versus 7.3 (5.6)°, p = 0.003; 7.7 (6.1)° versus 4.8 (5.8)°, p = 0.011), and were significantly lowered at M6 (respectively 10.9 (6.2)° versus 8.1 (4.8)°, p = 0.0087; and 7.7 (6.1)° versus 5.1 (4.7)°, p = 0.012), and became similar to the C-group. The dPT range of motion at M0 and M6 were similar, and were both significantly higher than control values. Mean values of maximum and minimum hip flexion were significantly higher at M0 compared to the C-group, and were significantly lowered at M6. No difference was found between the pre- and postoperative radiographic pelvic tilt. The VAS for lumbar pain, the VAS for radicular pain and the ODI were significantly decreased at M6. SIGNIFICANCE Compared to asymptomatic people, LSS patients walked with a pelvic anteversion, a hip flessum and a knee flessum before surgery, which tended to disappear after the surgical decompression. These differences were not noticed on static radiographs.
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Affiliation(s)
- Vincent Lamas
- Dijon University Hospital, Department of Orthopaedic Surgery, Dijon, France.
| | - Mathieu Gueugnon
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France.
| | | | - Michaël Grelat
- Dijon University Hospital, Department of Neurosurgery, Dijon, France.
| | - Jean-Francis Maillefert
- Dijon University Hospital, Department of Rheumatology, Dijon, France; INSERM, U1093, CAPS, Dijon, France.
| | - Paul Ornetti
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France; INSERM, U1093, CAPS, Dijon, France.
| | - Pierre Martz
- Dijon University Hospital, Department of Orthopaedic Surgery, Dijon, France; INSERM, U1093, CAPS, Dijon, France.
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20
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Ornetti P, Guillier D, Jeudy G. Perforating Rheumatoid Nodule Mimicking Malignant Soft-tissue Mass of the Forearm. J Rheumatol 2021; 48:1103. [PMID: 34074682 DOI: 10.3899/jrheum.201290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Paul Ornetti
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, and Plateforme d'investigation technologique, CIC-P, Rheumatology Department, François-Mitterrand Teaching Hospital
| | - David Guillier
- Plastic and Reconstructive Department, François-Mitterrand Teaching Hospital
| | - Geraldine Jeudy
- Dermatology Department, François-Mitterrand Teaching Hospital, Dijon, France
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21
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Dubief B, Avril J, Pascart T, Schmitt M, Loffroy R, Maillefert JF, Ornetti P, Ramon A. POS1129 OPTIMIZATION OF DUAL ENERGY COMPUTED TOMOGRAPHY POST-PROCESSING TO REDUCE LOWER LIMB ARTIFACTS IN GOUT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Dual energy computed tomography (DECT) is highly accurate for the diagnosis of gout. However, many artifacts have been described (1,2) such as nail bed, skin, beam hardening, sub-millimeter and vascular artifacts). Their presence can lead to a risk of over-diagnosis (false positives).Objectives:Main objective of this case-control study was to determine the optimal DECT settings post-treatment parameters (ratio and attenuation coefficient (HU)) in order to reduce the frequency of lower limb artifacts in patients with suspected gout of the lower limbs.Methods:Seventy-seven patients hospitalized for suspected gout arthritis (feet/ankles and/or knees) who received a DECT imaging were consecutively included (final diagnosis of 43 gout and 34 other rheumatic disorders). Different post-treatment settings were evaluated from the Syngovia software: an R1 (standard) setting with a ratio at 1.36 and minimum attenuation at 150 HU; an R2 setting with a ratio at 1.28 and minimum attenuation at 170 HU and an R3 setting with a ratio at 1.28 and minimum attenuation at 120 HU. The frequency of each artifact according to the 3 settings was determined. Diagnostic accuracy of R1 and R2 settings has been calculated. Correlations between artefacts and patient’s clinical characteristics were obtained by performing a Spearman test.Results:The R2 setting (170 HU, ratio=1.28) significantly reduced the presence of knee and foot/ankle artifacts compared to the standard R1 setting (85% and 94% decrease in beam hardening and clumpy artifacts in the ankle and foot, respectively (p < 0.001); a decrease of 71%, 60% and 88% respectively of meniscal beam hardening, beam hardening and submillimeter artifacts in the knee (p < 0.001). The use of R3 setting lead to a significant increase of some artifacts (clumpy artifacts, skin artifacts, beam hardening and nail beds.). In addition, our results found a positive correlation between the presence of deposits of knee menisci beam hardening chondrocalcinosis. Body mass index was also positively correlated with the presence of knee beam hardening artifact. Compared to standard setting, the use of R2 settings decreased sensitivity (0.79 [95CI: 0.65;0.88] versus 0.90 [95CI: 0.78;0.96] and increased specificity (0.86 [95CI: 0.71;0.93) versus 0.63 [95CI: 0.47;0.77] (p<0.001).Conclusion:Applying a ratio of 1.28 and a minimum attenuation of 170 HU (R2 settings) in DECT post-processing eliminates the majority of the artifacts located on the lower limbs, particularly the clumpy artifact and the beam hardening artifact.References:[1]Neogi T, Jansen TLTA, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2015;74:1789-98.[2]Mallinson PI, Coupal T, Reisinger C, Chou H, Munk PL, Nicolaou S, et al. Artifacts in dual-energy CT gout protocol: a review of 50 suspected cases with an artifact identification guide. AJR 2014;203:W103-109.Disclosure of Interests:None declared.
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22
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Ghesquière T, Ciudad M, Ramon A, Greigert H, Gerard C, Cladière C, Thébault M, Genet C, Devilliers H, Maurier F, Ornetti P, Quipourt V, Gabrielle PH, Creuzot-Garcher C, Tarris G, Martin L, Soudry-Faure A, Saas P, Audia S, Bonnotte B, Samson M. Mucosal-associated invariant T cells in Giant Cell Arteritis. J Autoimmun 2021; 121:102652. [PMID: 34000675 DOI: 10.1016/j.jaut.2021.102652] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to assess the implication of mucosal-associated invariant T (MAIT) cells in GCA. Blood samples were obtained from 34 GCA patients (before and after 3 months of treatment with glucocorticoids (GC) alone) and compared with 20 controls aged >50 years. MAIT cells, defined by a CD3+CD4-TCRγδ-TCRVα7.2+CD161+ phenotype, were analyzed by flow cytometry. After sorting, we assessed the ability of MAIT cells to proliferate and produce cytokines after stimulation with anti CD3/CD28 microbeads or IL-12 and IL-18. MAIT were stained in temporal artery biopsies (TAB) by confocal microscopy. MAIT cells were found in the arterial wall of positive TABs but was absent in negative TAB. MAIT frequency among total αβ-T cells was similar in the blood of patients and controls (0.52 vs. 0.57%; P = 0.43) and not modified after GC treatment (P = 0.82). Expression of IFN-γ was increased in MAIT cells from GCA patients compared to controls (44.49 vs. 32.9%; P = 0.029), and not modified after 3 months of GC therapy (P = 0.82). When they were stimulated with IL-12 and IL-18, MAIT from GCA patients produced very high levels of IFN-γ and displayed a stronger proliferation compared with MAIT from controls (proliferation index 3.39 vs. 1.4; P = 0.032). In GCA, the functional characteristics of MAIT cells are modified toward a pro-inflammatory phenotype and a stronger proliferation capability in response to IL-12 and IL-18, suggesting that MAIT might play a role in GCA pathogenesis. Our results support the use of treatments targeting IL-12/IL-18 to inhibit the IFN-γ pathway in GCA.
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Affiliation(s)
- Thibault Ghesquière
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - Marion Ciudad
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - André Ramon
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France; Department of Rheumatology, Dijon University Hospital, Dijon, France
| | - Hélène Greigert
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - Claire Gerard
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - Claudie Cladière
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - Marine Thébault
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - Coraline Genet
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - Hervé Devilliers
- Department of Internal Medicine and Systemic Diseases, Dijon University Hospital, Dijon, France
| | - François Maurier
- Department of Internal Medicine, Hospital Belle Isle, Metz, France
| | - Paul Ornetti
- Department of Rheumatology, Dijon University Hospital, Dijon, France; CIC-1432 Plateforme d'investigation Technologique Dijon University Hospital, INSERM UMR1093-CAPS, Université Bourgogne, Dijon, France
| | - Valérie Quipourt
- Department of Internal Medicine and Geriatrics, Dijon University Hospital, Dijon, France
| | | | | | - Georges Tarris
- Department of Pathology, CHU François Mitterrand, Dijon, France
| | - Laurent Martin
- Department of Pathology, CHU François Mitterrand, Dijon, France
| | - Agnès Soudry-Faure
- Unité de Soutien Méthodologique, DRCI, Dijon Bourgogne University Hospital, 21000, Dijon, France
| | - Philippe Saas
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France; CIC-1431, INSERM, Besançon University Hospital, EFS Bourgogne Franche-Comté, LabEx LipSTIC, F-25000, Besançon, France
| | - Sylvain Audia
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - Bernard Bonnotte
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-21000, Dijon, France.
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23
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Gueugnon M, Fournel I, Soilly AL, Diaz A, Baulot E, Bussière C, Casillas JM, Cherasse A, Conrozier T, Loeuille D, Maillefert JF, Mazalovic K, Timsit M, Wendling D, Ramon A, Binquet C, Morisset C, Ornetti P. Effectiveness, safety, and cost-utility of a knee brace in medial knee osteoarthritis: the ERGONOMIE randomized controlled trial. Osteoarthritis Cartilage 2021; 29:491-501. [PMID: 33524515 DOI: 10.1016/j.joca.2020.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 09/15/2020] [Accepted: 11/30/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This pragmatic, multicenter, open-label, randomized controlled trial (RCT) aimed to compare the effectiveness, safety, and cost-utility of a custom-made knee brace versus usual care over 1 year in medial knee osteoarthritis (OA). DESIGN 120 patients with medial knee OA (VAS pain at rest >40/100), classified as Kellgren-Lawrence grade II-IV, were randomized into two groups: ODRA plus usual care (ODRA group) and usual care alone (UCA group). The primary effectiveness outcome was the change in VAS pain between M0 and M12. Secondary outcomes included changes over 1 year in KOOS (function) and OAKHQOL (quality of life) scores. Drug consumption, compliance, safety of the knee brace, and cost-utility over 1 year were also assessed. RESULTS The ODRA group was associated with a higher improvement in: VAS pain (adjusted mean difference of -11.8; 95% CI: -21.1 to -2.5); all KOOS subscales (pain: +8.8; 95% CI: 1.4-16.2); other symptoms (+10.4; 95% CI: 2.7-18); function in activities of daily living (+9.2; 95% CI: 1.1-17.2); function in sports and leisure (+12.3; 95% CI: 4.3-20.3); quality of life (+9.9; 95% CI: 0.9-15.9), OAKHQOL subscales (pain: +14.8; 95% CI: 5.0-24.6); and physical activities (+8.2; 95% CI: 0.6-15.8), and with a significant decrease in analgesics consumption at M12 compared with the UCA group. Despite localized side-effects, observance was good at M12 (median: 5.3 h/day). The ODRA group had a more than 85% chance of being cost-effective for a willingness-to-pay threshold of €45 000 per QALY. CONCLUSIONS The ERGONOMIE RCT demonstrated significant clinical benefits of an unloader custom-made knee brace in terms of improvements in pain, function, and some aspects of quality of life over 1 year in medial knee OA, as well as its potential cost-utility from a societal perspective.
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Affiliation(s)
- M Gueugnon
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module Plurithématique, Plateforme D'Investigation Technologiques, Dijon, France CHU Dijon-Bourgogne, Dijon, France.
| | - I Fournel
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module EC, CHU Dijon-Bourgogne, Dijon, France.
| | - A-L Soilly
- Department of Clinical Research, Clinical Research Unit-Methodological Support Network CHU Dijon-Bourgogne, F-21000, Dijon, France.
| | - A Diaz
- Department of Rheumatology, CHU Dijon Bourgogne, F-21000 Dijon, France.
| | - E Baulot
- Department of Orthopedic Surgery, CHU Dijon Bourgogne, F-21000 Dijon, France; INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport.
| | - C Bussière
- Department of Orthopedic Surgery, Centre Orthopédique Medico-chirugical, Dracy-Le-Fort, France.
| | - J M Casillas
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module Plurithématique, Plateforme D'Investigation Technologiques, Dijon, France CHU Dijon-Bourgogne, Dijon, France; INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport; Department of Physical Medicine and Rehabilitation, CHU Dijon Bourgogne, F-2100 Dijon, France.
| | - A Cherasse
- Department of Rheumatology, Hospital Center Mâcon, Mâcon, France.
| | - T Conrozier
- Department of Rheumatology, Hospital Nord Franche-Comté, Belfort, France.
| | - D Loeuille
- Department of Rheumatology, CHU Nancy, F-54500 Vandoeuvre-lès-Nancy, France INSERM, CIC-EC CIE6, Nancy, France University Hospital of Nancy, Epidemiology and Clinical Evaluation, F-54500 Vandoeuvre-lès-Nancy, France.
| | - J-F Maillefert
- Department of Rheumatology, CHU Dijon Bourgogne, F-21000 Dijon, France; INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport.
| | - K Mazalovic
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module EC, CHU Dijon-Bourgogne, Dijon, France; Department of General Medicine, Bourgogne Franche-Comté University, UFR des Sciences de Santé, Dijon, France.
| | - M Timsit
- Department of Physical Medicine and Rehabilitation, Clinique de Provence Bourbonne, F-13400 Aubagne, France.
| | - D Wendling
- Department of Rheumatology, CHU Besançon EA4266 Bourgogne Franche-Comté University, F-25030 Besançon, France.
| | - A Ramon
- Department of Rheumatology, CHU Dijon Bourgogne, F-21000 Dijon, France.
| | - C Binquet
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module EC, CHU Dijon-Bourgogne, Dijon, France.
| | - C Morisset
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module Plurithématique, Plateforme D'Investigation Technologiques, Dijon, France CHU Dijon-Bourgogne, Dijon, France.
| | - P Ornetti
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module Plurithématique, Plateforme D'Investigation Technologiques, Dijon, France CHU Dijon-Bourgogne, Dijon, France; Department of Rheumatology, CHU Dijon Bourgogne, F-21000 Dijon, France; INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport.
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24
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Besson D, Gouteron A, Hannequin A, Casillas JM, Rigaud L, Ornetti P, Fournel I, Ksiazek E, Laroche D, Gueugnon M. Is the Short and Fast Step Test a safe and feasible tool for exploring anaerobic capacities of individuals with coronary heart disease in clinical practice? Eur J Phys Rehabil Med 2021; 57:977-984. [PMID: 33619946 DOI: 10.23736/s1973-9087.21.06713-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND While its importance in daily living, the anaerobic metabolism is not taken into account in clinical practice. The lack of validated functional performance tests for patients with chronic disabilities may explain this defect. In this context, the Short and Fast Step Test (SFST) was recently developed and validated in healthy volunteers. AIM The purpose of this study was to investigate the safety, feasibility and reliability of the SFST, a functional test exploring anaerobic metabolism in coronary patients during cardiac rehabilitation. DESIGN This study was a monocentric prospective study. SETTINGS This study took place in the rehabilitation center of the University Hospital Center of Dijon, France. POPULATION 44 coronary patients, addressed for a first cardiac rehabilitation, were included in this protocol. METHODS All participants performed three SFST: T1 and T2 (including respiratory gas exchange) the first day of the program and T3 after 3 to 7 days. SFST consists of walking up and down a 17.5cm-high step as many times as possible in 1 minute. Safety was assessed by the percentage of patients who performed the SFST without reporting a fall, or muscular or cardiovascular events. Feasibility was evaluated by the percentage of patients who succeeded in doing the SFST. Reliability was assessed with the number of raised steps in same condition (T1-T3) and different conditions (T1-T2) using a 2-way intraclass correlation coefficient (ICC). Values were given with their 90% confidence interval [90%CI]. RESULTS The safety was 95.2% [85.8;99.2] for T1, 88.1% [76.6;95.2] for T2 and 90.4% [79.5;96.7] for T3. 100% [93,1;100] of participants completed T1 and T2, 92.9% [82.6;98] T3. An ICC of 0.74 [0.60;0.84] was observed between T1 and T3 and of 0.87 [0.79;0.92] between T1 and T2. CONCLUSIONS This study demonstrates the good safety, feasibility and reliability of the SFST to assess anaerobic metabolism in coronary patients in a rehabilitation program. CLINICAL REHABILITATION IMPACT These results show that the SFST seems suitable for the evaluation of brief submaximal functional capacity in daily activities. It offers a real possibility to assess such capacity during the cardiac rehabilitation routine.
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Affiliation(s)
- Delphine Besson
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France
| | - Anais Gouteron
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France.,INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France
| | - Armelle Hannequin
- Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France
| | - Jean-Marie Casillas
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France.,INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France
| | - Lucie Rigaud
- Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France
| | - Paul Ornetti
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France.,Department of Rheumatology, CHU Dijon-Bourgogne, Dijon, France
| | - Isabelle Fournel
- INSERM, CIC1432, Clinical Epidemiology Unit, Dijon, France Dijon-Bourgogne University Hospital, Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials Unit, Dijon, France
| | - Elea Ksiazek
- INSERM, CIC1432, Clinical Epidemiology Unit, Dijon, France Dijon-Bourgogne University Hospital, Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials Unit, Dijon, France
| | - Davy Laroche
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France
| | - Mathieu Gueugnon
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France -
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25
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Schmitt M, Ramon A, Ornetti P, Maillefert JF. Validation of a Dutch diagnostic rule for gout without joint fluid analysis in patients hospitalized for acute monoarthritis. Rheumatology (Oxford) 2021; 60:979-981. [PMID: 33241291 DOI: 10.1093/rheumatology/keaa664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/01/2020] [Accepted: 08/12/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Marie Schmitt
- Department of Rheumatology, Dijon University Hospital
| | - André Ramon
- Department of Rheumatology, Dijon University Hospital.,INSERM UMR1098
| | - Paul Ornetti
- Department of Rheumatology, Dijon University Hospital.,INSERM CAPS UMR1093-CAPS, University of Burgundy.,Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon, France
| | - Jean Francis Maillefert
- Department of Rheumatology, Dijon University Hospital.,INSERM CAPS UMR1093-CAPS, University of Burgundy
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26
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Ramon A, Guillibert-Karras C, Milas-Julien L, Garrot JF, Maillefert JF, Ornetti P. The frequency of occult solid malignancy in patients with polymyalgia rheumatica-like symptoms. Ther Adv Musculoskelet Dis 2021; 13:1759720X20984275. [PMID: 33552239 PMCID: PMC7844447 DOI: 10.1177/1759720x20984275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/04/2020] [Indexed: 11/25/2022] Open
Abstract
Aims: We aim to evaluate the clinical usefulness of systematic screening for occult cancer in patients with polymyalgia rheumatic (PMR)-like symptoms in real-life practice. Methods: All patients seen by rheumatologists in Burgundy, France, between March 2016 and December 2018 for new-onset PMR that met the 2012 ACR/EULAR classification criteria were prospectively included. Patients underwent systematic screening including determination of the erythrocyte sedimentation rate, serum C-reactive protein levels, thoracic, abdominal and pelvic computed tomography (CT-TAP) and, in men, serum prostate-specific antigen. The standardized incidence ratio (SIR) for cancers was calculated using 2012 national estimates of cancer incidence. Potential predictive factors for the diagnosis of cancer were then evaluated using univariate and multivariate analyses. Results: Among the 118 patients included, nine cases of cancer were confirmed and diagnosed with CT-TAP: kidney carcinoma (n = 4), lung cancer (n = 2), pancreatic, colon, and ampullary carcinoma (n = 1 each). Among these cancers, five were localized (four kidney, and one ampullary carcinoma) and were treated with complete surgical resection. The expected incidence of cancer in the general population was 1.95, leading to an overall SIR of 4.6 (95% CI 2.4–8.9, p < 0.0001). An additional analysis was performed for the kidney carcinoma, and it showed a highly significant increase in SIR: 80.8 (95% CI 30.3–215.4). In 80% of patients, the PMR-like syndrome regressed during cancer treatment. No other predictive factors for cancer were found. Conclusion: Systematic screening for cancer including CT-TAP in real-life practice revealed occult solid malignancy, mostly early-stage cancer, in a relevant proportion of patients presenting PMR-like symptoms. The high proportion of kidney cancer (40%) is worth highlighting, especially considering that it is not one of the most frequent cancers after 50 years of age.
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Affiliation(s)
- André Ramon
- Department of Rheumatology, Dijon University Hospital, Dijon, France
| | | | | | | | | | - Paul Ornetti
- Department of Rheumatology, INSERM, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon, France
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27
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Peran M, Allado E, Albuisson E, Couderc M, Ornetti P, Roux C, Grosse J, Chary-Valckenaere I, Loeuille D. Performance of ultrasound to assess erosion progression in rheumatoid arthritis. Eur J Radiol 2021; 136:109536. [PMID: 33465551 DOI: 10.1016/j.ejrad.2021.109536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/07/2020] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To analyse the performance of ultrasonography (US) to detect bone erosion progression at the patient level and at the joint level by the US score for erosions (USSe) in early-stage and late-stage rheumatoid arthritis (RA) over a 2-year follow-up. METHODS Clinical and demographic information was recorded at baseline, and hands and feet RX were scored according to the Sharp erosion score. USSe was performed at baseline and over 2 years of follow-up on six bilateral joints (MCP2, 3, 5; MTP2, 3, 5). Inter-examiner reproducibility was performed on 14 patients, and the smallest detectable change (SDC) was calculated. US progression was defined as a change in USSe > SDC. RESULTS 71 patients were included: 22 (31.0 %) early RA, and 49 (69.0 %) late RA. The intra-class correlation coefficient values of the USSe for intra- and inter-examiner studies were 0.96 (CI95: 0.93-0.98), and 0.92 (CI95: 0.75-0.97), respectively. On US, erosions prevailed at baseline in MTP5 joints followed by MCP2 and MCP5 joints. With an SDC calculated at 2.3, 28 patients (39.4 %) were classified as progressors, 30 (42.3 %) were stable, and 13 (18.3 %) were regressors during the follow-up. At the joint level, erosion progression was significant on the MCP2 and MTP5 joints in early RA (p < 0.01) and on the MCP5 and MTP5 joints for all RA (p < 0.05). CONCLUSIONS US is a highly reproducible method that is able to detect erosion progression at the patient level for both early and late RA and at the joint level (MCP2 and MTP5) for only early RA.
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Affiliation(s)
- Manon Peran
- Department of Rheumatology, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France.
| | - Edem Allado
- Center of Sports Medicine and Adapted Physical Activity, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France
| | - Eliane Albuisson
- Platform of Clinical Research Support PARC (MDS Unity), University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France
| | - Marion Couderc
- Department of Rheumatology, University Hospital of Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Paul Ornetti
- Department of Rheumatology, University Hospital of Dijon, 21000, Dijon, France; INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, F-21000, Dijon, France
| | - Camille Roux
- Department of Rheumatology, Hospital of Metz, 57000, Metz, France
| | - Julien Grosse
- Department of Rheumatology, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France
| | - Isabelle Chary-Valckenaere
- Department of Rheumatology, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France; Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), UMR 7365 CNRS - University of Lorraine, 54500, Vandoeuvre-lès-Nancy, France
| | - Damien Loeuille
- Department of Rheumatology, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France; Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), UMR 7365 CNRS - University of Lorraine, 54500, Vandoeuvre-lès-Nancy, France
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28
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Eymard F, Ornetti P, Maillet J, Noel É, Adam P, Legré-Boyer V, Boyer T, Allali F, Gremeaux V, Kaux JF, Louati K, Lamontagne M, Michel F, Richette P, Bard H. Correction to: Intra‑articular injections of platelet‑rich plasma in symptomatic knee osteoarthritis: a consensus statement from French‑speaking experts. Knee Surg Sports Traumatol Arthrosc 2021; 29:3211-3212. [PMID: 33097967 PMCID: PMC8458210 DOI: 10.1007/s00167-020-06331-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The article Intra‑articular injections of platelet‑rich plasma in symptomatic knee osteoarthritis: a consensus statement from French‑speaking experts, written by Florent Eymard, Paul Ornetti, Jérémy Maillet, Éric Noel, Philippe Adam, Virginie Legre-Boyer, Thierry Boyer, Fadoua Allali, Vincent Gremeaux, Jean-Francois Kaux, Karine Louati, Martin Lamontagne, Fabrice Michel, Pascal Richette, Hervé Bard on behalf of the GRIP (Groupe de Recherche sur les Injections de PRP, PRP Injection Research Group), was originally published electronically on the publisher’s internet portal on 24 June 2020 without open access.
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Affiliation(s)
- Florent Eymard
- Department of Rheumatology, AP-HP Henri Mondor Hospital, 94010 Créteil Cedex, France
| | - Paul Ornetti
- Department of Rheumatology, Plateforme d’Investigations Technologiques Dijon University Hospital, INSERM 1093 CAPS, Dijon, France
| | - Jérémy Maillet
- Department of Rheumatology, AP-HP Lariboisière Hospital, 75010 Paris, France
| | - Éric Noel
- Santy Orthopedic Center, 69008 Lyon, France
| | - Philippe Adam
- Imaging Department, Medipole Garonne Sport Clinic, 31100 Toulouse, France
| | | | | | - Fadoua Allali
- Department of Rheumatology, El Ayachi Hospital, Salé, Morocco
| | - Vincent Gremeaux
- Sport Medicine Unit, Division of Physical Medicine and Rehabilitation, Swiss Olympic Medical Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Jean-François Kaux
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, FIFA Medical Centre of Excellence, IOC Research for Prevention of Injury and Protection of Athlete Health, FIMS Clinical Centre of Sports Medicine, University and University Hospital of Liège, 4000 Liège, Belgium
| | - Karine Louati
- Department of Rheumatology, AP-HP Saint-Antoine Hospital, 75012 Paris, France
| | | | - Fabrice Michel
- Physical Medicine and Rehabilitation Department, CHRU hôpital Jean-Minjoz, 25000 Besançon, France
| | - Pascal Richette
- Department of Rheumatology, AP-HP Lariboisière Hospital, 75010 Paris, France
| | - Hervé Bard
- Cabinet médical Vaudoyer, 75007, Paris, France.
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29
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Labarrière F, Thomas E, Calistri L, Optasanu V, Gueugnon M, Ornetti P, Laroche D. Machine Learning Approaches for Activity Recognition and/or Activity Prediction in Locomotion Assistive Devices-A Systematic Review. Sensors (Basel) 2020; 20:E6345. [PMID: 33172158 PMCID: PMC7664393 DOI: 10.3390/s20216345] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/22/2020] [Accepted: 11/04/2020] [Indexed: 01/16/2023]
Abstract
Locomotion assistive devices equipped with a microprocessor can potentially automatically adapt their behavior when the user is transitioning from one locomotion mode to another. Many developments in the field have come from machine learning driven controllers on locomotion assistive devices that recognize/predict the current locomotion mode or the upcoming one. This review synthesizes the machine learning algorithms designed to recognize or to predict a locomotion mode in order to automatically adapt the behavior of a locomotion assistive device. A systematic review was conducted on the Web of Science and MEDLINE databases (as well as in the retrieved papers) to identify articles published between 1 January 2000 to 31 July 2020. This systematic review is reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and is registered on Prospero (CRD42020149352). Study characteristics, sensors and algorithms used, accuracy and robustness were also summarized. In total, 1343 records were identified and 58 studies were included in this review. The experimental condition which was most often investigated was level ground walking along with stair and ramp ascent/descent activities. The machine learning algorithms implemented in the included studies reached global mean accuracies of around 90%. However, the robustness of those algorithms seems to be more broadly evaluated, notably, in everyday life. We also propose some guidelines for homogenizing future reports.
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Affiliation(s)
- Floriant Labarrière
- INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (F.L.); (E.T.); (P.O.)
| | - Elizabeth Thomas
- INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (F.L.); (E.T.); (P.O.)
| | - Laurine Calistri
- PROTEOR, 6 rue de la Redoute, CS 37833, CEDEX 21078 Dijon, France;
| | - Virgil Optasanu
- ICB, UMR 6303 CNRS, Université de Bourgogne Franche Comté 9 Av. Alain Savary, CEDEX 21078 Dijon, France;
| | - Mathieu Gueugnon
- INSERM, CIC 1432, Module Plurithematique, Plateforme d’Investigation Technologique, CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21079 Dijon, France;
| | - Paul Ornetti
- INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (F.L.); (E.T.); (P.O.)
- INSERM, CIC 1432, Module Plurithematique, Plateforme d’Investigation Technologique, CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21079 Dijon, France;
- Department of Rheumatology, Dijon University Hospital, 21079 Dijon, France
| | - Davy Laroche
- INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (F.L.); (E.T.); (P.O.)
- INSERM, CIC 1432, Module Plurithematique, Plateforme d’Investigation Technologique, CHU Dijon-Bourgogne, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, 21079 Dijon, France;
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30
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Richette P, Latourte A, Sellam J, Wendling D, Piperno M, Goupille P, Pers YM, Eymard F, Ottaviani S, Ornetti P, Flipo RM, Fautrel B, Peyr O, Bertola JP, Vicaut E, Chevalier X. Efficacy of tocilizumab in patients with hand osteoarthritis: double blind, randomised, placebo-controlled, multicentre trial. Ann Rheum Dis 2020; 80:349-355. [PMID: 33055078 DOI: 10.1136/annrheumdis-2020-218547] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/15/2020] [Accepted: 09/24/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the efficacy of tocilizumab, an antibody against IL-6 receptor, in patients with hand osteoarthritis. METHODS This was a multicentre, 12-week, randomised, double-blind, placebo-controlled study from November 2015 to October 2018. Patients with symptomatic hand osteoarthritis (pain ≥40 on a 0-100 mm visual analogue scale (VAS) despite analgesics and non-steroidal anti-inflammatory drugs; at least three painful joints, Kellgren-Lawrence grade ≥2) were randomised to receive two infusions 4 weeks apart (weeks 0 and 4) of tocilizumab (8 mg/kg intravenous) or placebo. The primary endpoint was changed in VAS pain at week 6. Secondary outcomes included the number of painful and swollen joints, duration of morning stiffness, patients' and physicians' global assessment and function scores. RESULTS Of 104 patients screened, 91 (45 to tocilizumab and 46 to placebo; 82% women; mean age 64.4 (SD 8.7) years) were randomly assigned and 79 completed the 12-week study visit. The mean change between baseline and week 6 on the VAS for pain (primary outcome) was -7.9 (SD 19.4) and -9.9 (SD 20.1) in the tocilizumab and placebo groups (p=0.7). The groups did not differ for any secondary outcomes at weeks 4, 6, 8 or 12. Overall, adverse events were slightly more frequent in the tocilizumab than placebo group. CONCLUSION Tocilizumab was no more effective than placebo for pain relief in patients with hand osteoarthritis.
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Affiliation(s)
- Pascal Richette
- APHP, Hôpital Lariboisière, Service de Rhumatologie, Paris, France .,Université de Paris, Inserm, UMR-S 1132, Bioscar, Paris, France
| | - Augustin Latourte
- APHP, Hôpital Lariboisière, Service de Rhumatologie, Paris, France.,Université de Paris, Inserm, UMR-S 1132, Bioscar, Paris, France
| | - Jérémie Sellam
- Rheumatology, INSERM UMRS_938, Sorbonnes Université UPMC Univ Paris 06, St-Antoine Hospital, DHU i2B, Paris, France
| | | | | | | | - Yves-Marie Pers
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, CHRU Lapeyronie, Montpellier, France
| | - Florent Eymard
- Department of Rheumatology, APHP Henri Mondor Hospital, Créteil, France.,Universite Paris-Est Creteil Val de Marne, Creteil, Île-de-France, France
| | | | - Paul Ornetti
- Rheumatology, Burgundy Franche-Comté University, Dijon, France.,Dijon University Hospital, Dijon, France
| | - René-Marc Flipo
- Service de Rhumatologie, CHU Roger Salengro, Université de Lille, Lille, France
| | - Bruno Fautrel
- Rheumatology, Assistance Publique - Hopitaux de Paris, Paris, France.,GRC08 - IPLESP, UPMC Faculte de Medecine, Paris, France
| | - Olivier Peyr
- Service de Rhumatologie, Hopital Lariboisiere Centre Viggo Petersen, Paris, Île-de-France, France
| | | | - Eric Vicaut
- Unité de recherche clinique, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, Île-de-France, France
| | - Xavier Chevalier
- Department of Rheumatology, APHP Henri Mondor Hospital, Créteil, France.,Universite Paris-Est Creteil Val de Marne, Creteil, Île-de-France, France
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31
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Sellam J, Courties A, Eymard F, Ferrero S, Latourte A, Ornetti P, Bannwarth B, Baumann L, Berenbaum F, Chevalier X, Ea HK, Fabre MC, Forestier R, Grange L, Lellouche H, Maillet J, Mainard D, Perrot S, Rannou F, Rat AC, Roux CH, Senbel E, Richette P. Recommendations of the French Society of Rheumatology on pharmacological treatment of knee osteoarthritis. Joint Bone Spine 2020; 87:548-555. [PMID: 32931933 DOI: 10.1016/j.jbspin.2020.09.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To establish recommendations for pharmacological treatment of knee osteoarthritis specific to France. METHODS On behalf of the French Society of Rheumatology (SFR), a bibliography group analyzed the literature on the efficacy and safety of each pharmacological treatment for knee osteoarthritis. This group joined a multidisciplinary working group to draw up recommendations. Strength of recommendation and quality of evidence level were assigned to each recommendation. A review committee gave its level of agreement. RESULTS Five general principles were established: 1) need to combine pharmacological and non-pharmacological treatments, 2) personalization of treatment, 3) symptomatic and/or functional aim of pharmacological treatments, 4) need to regularly re-assess the treatments and 5) discussion about arthroplasty if medical treatment fails. Six recommendations involved oral treatments: 1) paracetamol should not necessarily be prescribed systematically and/or continuously, 2) NSAIDs, possibly as first-line, 3) weak opioids, 4) strong opioids, 5) symptomatic slow-acting drugs of osteoarthritis, and 6) duloxetine (off-label use). Two recommendations involved topical agents (NSAIDs and capsaicin<1%). Three recommendations involved intra-articular treatments: corticosteroid or hyaluronic acid injections that can be proposed to patients. The experts did not draw a conclusion about the benefits of platelet-rich plasma injections. CONCLUSION These are the first recommendations of the SFR on the pharmacological treatment of knee osteoarthritis.
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Affiliation(s)
- Jérémie Sellam
- Service de rhumatologie, Assistance Publique-Hôpitaux de Paris (AP-HP), hôpital Saint-Antoine, Sorbonne Université, Inserm UMRS_938, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
| | - Alice Courties
- Service de rhumatologie, Assistance Publique-Hôpitaux de Paris (AP-HP), hôpital Saint-Antoine, Sorbonne Université, Inserm UMRS_938, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - Florent Eymard
- Service de rhumatologie, Hôpital Henri Mondor, AP-HP, 94000 Créteil, France
| | - Stéphanie Ferrero
- Service de rhumatologie, LAMHESS, université Cote d'Azur, CHU de Nice, 06000 Nice, France
| | - Augustin Latourte
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 75010 Paris, France
| | - Paul Ornetti
- Service de rhumatologie, CHU de Dijon, 21000 Dijon, France
| | | | | | - Francis Berenbaum
- Service de rhumatologie, Assistance Publique-Hôpitaux de Paris (AP-HP), hôpital Saint-Antoine, Sorbonne Université, Inserm UMRS_938, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - Xavier Chevalier
- Service de rhumatologie, Hôpital Henri Mondor, AP-HP, 94000 Créteil, France
| | - Hang Korng Ea
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 75010 Paris, France
| | | | - Romain Forestier
- Centre de recherche rhumatologique et thermale, 73100 Aix-les-Bains, France
| | - Laurent Grange
- Service de rhumatologie, AFLAR, CHU de Grenoble-Alpes, 38000 Grenoble/Paris, France
| | - Henri Lellouche
- Cabinet libéral et service de rhumatologie, hôpital Lariboisière, AP-HP, 75010 Paris, France
| | - Jérémy Maillet
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 75010 Paris, France
| | - Didier Mainard
- Service de chirurgie orthopédique, CHU de Nancy, 54000 Nancy, France
| | - Serge Perrot
- Centre d'évaluation et traitement de la douleur, hôpital Cochin, AP-HP, 75014 Paris, France
| | - François Rannou
- Service de rééducation et de réadaptation de l'appareil locomoteur et des pathologies du Rachis, centre-université de Paris, hôpital Cochin, université de Paris, AP-HP, 75014 Paris, France
| | | | - Christian H Roux
- Service de rhumatologie, LAMHESS, université Cote d'Azur, CHU de Nice, 06000 Nice, France
| | - Eric Senbel
- Cabinet libéral et service de rhumatologie, Hôpital Sainte-Marguerite, 13000, Marseille, France
| | - Pascal Richette
- Service de rhumatologie, hôpital Lariboisière, AP-HP, 75010 Paris, France
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- Faculté de santé, UFR médecine de Paris-Centre, 75006 Paris, France
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Schmitt M, Ramon A, Ornetti P, Maillefert JF. THU0441 DIAGNOSTIC ACCURACY OF THE NIJMENGEN SCORE FOR GOUTY ARTHRITIS IN PATIENTS HOSPITALIZED FOR ACUTE MONOARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The gold-standard for diagnosis of gout is the identification of monosodium urate (MSU) crystal in joint fluid. However, the sensitivity, specificity, and reproducibility of such analysis are not excellent, and joint aspiration is sometimes difficult, or impossible. The Nijmengen score is an easy-to-use rule without joint fluid analysis with excellent validity, in primary as well as in secondary care (1, 2). However, it’s validity as not been evaluated in the particular situation of patients whose acute arthritis necessitates hospitalization.Objectives:The objective of the present study was to assess diagnosis performances of the score in patients hospitalized for acute monoarthritis.Methods:Inclusion: all patients hospitalized for acute monoarthritis in the rheumatology department of the Dijon University Hospital between 2016 and 2019.Assessment: 1- clinical examination by an experimented rheumatologist; 2- joint aspiration and synovial fluid analysis following aspiration; 3- ultrasound (US) examination of the knees, first metatarso-phalangeal joints, and arthritic joint by a trained rheumatologist; 4- dual-energy computed tomography (DECT) of the arthritic joint; 5- Nijmengen score (cutoff scores of ≥ 8 needed for diagnosis of gout, and ≤ 4 to rule out gout) and ACR/EULAR 2015 classification criteria (3) (cut-off score of ≥ 8 needed for diagnosis of gout).Analysis: positive and negative predictive values, and ROC curve analysis of the Nijmengen score, using as gold-standard on one hand the results of the MSU crystal research, on the other hand those of the ACR/EULAR criteria.Results:A total of 39 patients were included (mean age = 69.8 ± 15 years, 74.4 % males, mean BMI = 27.5 ± 4.6 Kg/m2, mean serum uric acid = 354.6 ± 117.5 µmol/l). The affected joints were the knee (n = 31), ankle (n = 3), hip (n = 2), wrist (n = 2), shoulder (n = 1). Joint fluid analysis revealed MSU crystal in 11 patients. The ACR/EULAR was ≥ 8 in 15 patients. The Nijmengen score was ≥ 8 in 11 patients, including 5 with MSU crystal on joint fluid analysis and 9 with an ACR/EULAR score ≥ 8. The Nijmengen score was ≤ 4 in 15 patients, including 14 with no MSU crystal on joint fluid analysis and 14 with an ACR/EULAR score < 8. The positive predictive values of a Nijmengen score ≥ 8 were 45 % (joint fluid analysis as gold standard) and 81.8 % (ACR/EULAR). The negative predictive values of a Nijmengen score ≤ 4 were 93.3 % (joint fluid analysis and ACR/EULAR as gold standard). On ROC curve analyses, the areas under the curve were 0.763 (95% CI = 0.612 – 0.914) using joint fluid analysis as gold standard (figure 1) and 0.908 (95% CI = 0.814 – 1.0) using the ACR/EULAR score as gold standard (figure 2).Fig. 1ROC curve (fluid analysis as gold standard)Fig. 2Roc curve (ACR/EULAR as gold standard)Conclusion:Although having been developed for use in primary-care, the Nijmengen score appears to be useful in patients hospitalized for acute monoarthritis in a rheumatology unit.References:[1]Janssens et al. A diagnostic rule for acute gouty arthritis in primary care without joint fluid analysis. Arch Intern Med 2010; 170:1120-6.[2]Kienhorst L et al. The validation of a diagnostic rule for gout without joint fluid analysis: a prospective study. Rheumatology 2015; 54:609-14.[3]Neogi T et al. 2015 Gout Classification Criteria: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative: ACR/EULAR CLASSIFICATION CRITERIA FOR GOUT. Arthritis and Rheumatology. oct 2015;67(10):2557-68.Disclosure of Interests: :marie Schmitt: None declared, André Ramon: None declared, Paul Ornetti: None declared, jean Francis Maillefert Grant/research support from: Abbot, shugai, Roche, pfiser, BMS,, Speakers bureau: Abbot, Shugai, Roche, Pfiser, BMS
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Peran M, Allado E, Albuisson E, Couderc M, Ornetti P, Roux C, Grosse J, Chary Valckenaere I, Loeuille D. AB1125 PERFORMANCE OF ULTRASOUNDS TO ASSESS EROSION PROGRESSION IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Ultrasonography (US) can detect more erosions than radiography (RX) at the joint level in rheumatoid arthritis (RA), especially at an early stage of the disease.Objectives:The aim of the study is to determine the ability of ultrasonography to detect erosion progression by the US Score for erosions (USSe), in early (less than 2 years disease duration (DD)) and late stage (more than 2 years DD) RA over two years of follow-up.Methods:Patients fulfilling ACR 1987 and/or ACR/EULAR 2010 criteria for RA were prospectively included. Clinical and demographic informations were recorded at baseline and hands and feet RX were scored according to the Sharp erosion score (SHSe). Erosive RA on RX was defined by the presence of at least three eroded joints (1). US examinations were performed at baseline and during the two years of follow-up. Erosions were scored by US on six bilateral joints (MCP 2, 3, 5 and MTP 2, 3, 5) with a four grade-scale to calculate total USSe. Erosive RA on US was defined by presence of one erosion ≥ 2mm (2). Inter-examiner reproducibility was performed on 14 patients in order to calculate the smallest detectable change (SDC), which was 2.3. Ultrasonographic progression was defined as a change in USSe > 2 (erosion change > SDC).Results:A total of 71 patients were included, 22 patients (31.0%) had early RA and 49 (69.0%) patients had late RA diseases. On RX, 30 (42.3%) patients were erosive at baseline with a mean SHSe at 29.4 (SD at 24.7). On US, 63 patients (88.7%) were classified as eroded. On US, erosions prevailed at baseline in MTP5 joints, then MCP2 and MCP5 joints on their lateral facets. During follow-up, 28 patients (39.4%) were classified as US progressors, 30 (42.3%) were stable and 13 (18.3%) considered as regressors (figure 1). In early RA disease, three of the four non eroded patients became eroded. USSe progressed in 11 patients (50%) while regression was observed in only one patient. In late RA disease, 17 patients (34.7%) progressed and 12 patients (24.5%) decreased significantly their USSe. Erosion progression prevailed on MTP 5 joints followed by MCP2 and finally MCP5 joints (figure 2).Figure 1.USSe progression plots (n=71)Figure 2.Differences of USSe by joints during follow-up in early and late RAConclusion:US structural examination is a highly reproducible method to assess erosion in RA disease. The USSe is able to detect structural changes (progression, stabilization and regression) in RA patients during a follow-up of two years especially in RA patients with short disease duration.References:[1]Van der Heijde D, van der Helm-van Mil AHM, Aletaha D, Bingham CO, Burmester GR, Dougados M, et al. EULAR definition of erosive disease in light of the 2010 ACR/EULAR rheumatoid arthritis classification criteria. Ann Rheum Dis. avr 2013;72(4):479‑81.[2]Roux C, Gandjbakhch F, Pierreisnard A, Couderc M, Lukas C, Masri R, et al. Optimization of ultrasonographic examination for the diagnosis of erosive Rheumatoid Arthritis in comparison to erosive hand Osteoarthritis. Eur J Radiol. sept 2019;118:10‑8.Disclosure of Interests:None declared
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Ramon A, Fayolle C, Devilliers H, Piroth C, Herrada I, Attane G, Wendling D, Ornetti P. AB0718 DIAGNOSTIC PERFORMANCE OF VARIOUS CLASSIFICATION CRITERIA IN LOW BACK PAIN PATIENTS WITH SUSPECTED AXIAL SPONDYLOARTHRITIS: A PRAGMATIC STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In routine practice, axial spondyloarthritis (SpA) can be a diagnostic challenge because there is potential overlap with osteoarthritic low back pain or diffuse polyalgic syndrome with axial pain as fibromyalgia. Internationally recognized classification criteria (AMOR, ASAS (1), ESSG (2)) are often used as diagnostic tools in clinical practice (3), but few studies have sought to establish their “real life” diagnostic performances.Objectives:This monocentric study aimed to evaluate the diagnostic performance of different sets of classification criteria for SpA in patients with chronic back pain hospitalized for suspected axial SpA. The second objective was to evaluate the impact of the sacroiliac MRI reading according to the ASAS MRI reading or expert musculoskeletal reading.Methods:Patients presenting with inflammatory low back pain who underwent standardized sacroiliac MRI protocol were consecutively included. The diagnoses obtained with the classification criteria (AMOR, ESSG, Modified AMOR and Modified ESSG (with sacroiliac MRI)) were compared to the gold standard diagnoses (made by a college of three experienced rheumatologists). Two readings of the sacroiliac MRI were performed (ASAS MRI reading and Expert MRI reading (including all inflammatory or structural T1 or T2 STIR abnormalities)). Diagnostic performance was measured for each set of classification criteria: sensitivity, specificity, predictive positive and negative values (PPV, NPV) and positive and negative likelihood ratios (PLR, PLN). The clinical, biological and MRI factors associated with axial SpA diagnosis were identified in a multivariate logistic regression model.Results:83 patients were included of which 27 had axial SpA according to the opinion of the college of rheumatologists. The AMOR modified criteria (with ASAS MRI reading) had the highest diagnostic performance values, with sensitivity = 96%, specificity = 71%, NPV = 97%, PPV = 54%, PLR = 3.3, and NLR = 0.06. Sacroiliac MRI reading demonstrated poor sensitivity (< 60%) for SpA (ASAS or expert reading), while expert reading of MRI had high specificity (98%), NPV = 90%, PPV = 78%, and PLR = 18. In multivariate logistic regression, the presence of enthesitis (OR = 3.51, IC95% [1.10;11.21]; p = 0.024), positive HLA B27 (OR = 4.22, IC95% [1.25;14.18]; p = 0.02)) or sacroiliitis on MRI (ASAS reading) (OR = 3.34, IC95% [1.04; 10.76]; p = 0.043) were independently associated with the final diagnosis of SpA.Conclusion:The results of this pragmatic study suggest that the Modified AMOR criteria with ASAS MRI reading can be used to rule out axial spondyloarthritis (NPV = 97%). However, the use of an MRI ASAS reading alone creates a risk of false positives because of the greater impact on ASAS criteria compared to AMOR or ESSG criteria. Further international studies are needed to decrease the rate of false positives in suspected cases of axial spondyloarthritis in routine practice.References:[1]Dougados M, van der Linden S, Juhlin R et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 1991;34:1218-27.[2]Rudwaleit M, van der Heijde D, Landewé R et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68:777-83.[3]Gazeau P, Cornec D, Timsit MA et al. Classification criteria versus physician’s opinion for considering a patient with inflammatory back pain as suffering from spondyloarthritis. Joint Bone Spine 2018;85:85-91.Disclosure of Interests:None declared
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Eymard F, Ornetti P, Maillet J, Noel E, Adam P, Legré Boyer V, Boyer T, Allali F, Grémeaux Bader V, Kaux JF, Louati K, Lamontagne M, Michel F, Richette P, Bard H. AB0862 CONSENSUS STATEMENT ON INTRA-ARTICULAR INJECTIONS OF PLATELET-RICH PLASMA FOR THE MANAGEMENT OF KNEE OSTEOARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:There has been much debate regarding the use of intra-articular injections of platelet-rich plasma (PRP) as symptomatic treatment for knee osteoarthritis. The heterogeneity of the preparation and injection protocols limits the extrapolation of data from randomized controlled trials and meta-analyses.Objectives:The objective of this expert consensus was to develop the first clinical practice recommendations for PRP injections in knee osteoarthritis.Methods:Fifteen physicians (10 rheumatologists, 4 specialists in rehabilitation and sport medicine and 1 interventional radiologist) from different countries were selected given to their expertise in the fields of PRP and osteoarthritis. Twenty-five recommendations were finally retained after several meetings using the modified Delphi method to establish clinical consensus. All experts voted their agreement or not for each recommendation using a score between 1 (totally inappropriate) and 9 (totally appropriate). Depending on the median value and extreme scores, recommendations were judged as appropriated or unappropriated with a strong or relative agreement but could also be judged as uncertain due to indecision or absence of consensus.Results:The main recommendations are listed below:- Intra-articular injections of PRP constitute an efficient treatment of early or moderate symptomatic knee osteoarthritis. Median = 8 [6-9] – Appropriate. Relative agreement.- Intra-articular injections of PRP may be useful in severe knee osteoarthritis (Kellgren-Lawrence grade IV). Median = 7 [6-7] – Appropriate. Relative agreement.- Intra-articular injections of PRP in knee osteoarthritis should be proposed as second-line therapy, after failure of non-pharmacological and pharmacological (oral and topic) symptomatic treatment. Median = 9 [5-9] – Appropriate. Relative agreement.- Intra-articular injections of PRP should not be performed in osteoarthritis flare-up with significant effusion. Median = 7 [5-9] – Appropriate. Relative agreement.- Intra-articular PRP treatment may include 1 to 3 consecutive injections. Median = 9 [7-9] – Appropriate. Strong agreement.- Leukocyte-poor PRP should be preferred for knee OA treatment. Median = 8 [5-9] – Appropriate. Relative agreement.- PRP injections should be performed under ultrasound or fluoroscopic guidance. Median = 8 [3-9] – Uncertain. No consensus.- PRP should not be mixed with injectable anesthetic or corticosteroid. Median = 9 [6-9] – Appropriate. Relative agreement.Conclusion:Twenty-five recommendations were discussed by an international multidisciplinary task force group in order to provide a basis for standardization of clinical practices and future research protocols.Disclosure of Interests:Florent Eymard Consultant of: Regenlab, Paul Ornetti: None declared, Jérémy Maillet Consultant of: Regenlab, Eric Noel Consultant of: Regenlab, Philippe Adam Consultant of: Regenlab, Virginie Legré Boyer Consultant of: Regenlab, Thierry Boyer Consultant of: Regenlab, Fadoua Allali: None declared, Vincent Grémeaux Bader: None declared, Jean-François Kaux: None declared, Karine Louati: None declared, Martin Lamontagne Consultant of: Pendopharm, Fabrice Michel: None declared, Pascal Richette: None declared, Hervé Bard Consultant of: Regenlab
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Moissenet F, Naaim A, Ornetti P, Bourredjem A, Binquet C, Morisset C, Gouteron A, Maillefert JF, Laroche D. Is the Pelvis-Thorax Coordination a Valuable Outcome Instrument to Assess Patients With Hip Osteoarthritis? Front Bioeng Biotechnol 2020; 7:457. [PMID: 32039174 PMCID: PMC6990408 DOI: 10.3389/fbioe.2019.00457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/19/2019] [Indexed: 12/04/2022] Open
Abstract
Objective: The evaluation of the disease severity in hip osteoarthritis (OA) patients being currently based on subjective instruments. It would be of interest to develop more objective instruments, for example based on gait analysis. The aims of this study were to explore if pelvis-thorax coordination parameters could be valuable instrument outcomes to achieve this evaluation by assessing their reliability, discriminant capacity and responsiveness. Methods: Three groups of subjects; healthy, hip OA patients with severe disease (defined as indication to surgery), hip OA patients with less severe disease (no indication to surgery) were included. Hip OA patients with severe disease were evaluated before and 6 months after surgery. Subjects had to perform a gait analysis at comfortable speed, and pelvis-thorax coordination was evaluated. The correlations with clinical and structural parameters, as well as reliability, discriminant capacities and responsiveness, were assessed. Results: The pelvis-thorax coordination in the coronal plane during walking was correlated to clinical and to structural severity in hip OA patients (R2 = 0.13). The coronal plane coordination allowed to discriminate healthy subjects from all hip OA patients (sensibility = 0.86; specificity = 0.59). Moreover, when comparing OA patients only, coronal plane coordination allows to discriminate patients with indication of surgery from those with no indication of surgery (sensibility = 0.72; specificity = 0.72). Moreover, the pelvis-thorax coordination demonstrated an excellent reliability and a good responsiveness. Conclusion: Changes in the pelvis-thorax coordination might refer to different mechanisms, from analgesia to motor control plasticity, and might be a possible explanation for the weak correlation between structure and symptoms in hip OA patients. Moreover, such parameter might be used as an objective outcome in hip OA clinical trials. Clinical Trials Registration:www.ClinicalTrials.gov, identifier: NCT02042586 and NCT01907503.
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Affiliation(s)
| | - Alexandre Naaim
- Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR T9406, Lyon, France
| | - Paul Ornetti
- Centre Hospitalier Universitaire Dijon-Bourgogne, Service de Rhumatologie, Dijon, France.,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France; CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France.,INSERM UMR 1093, Cognition, Action et Plasticité sensorimotrice, Dijon; Université de Bourgogne Franche Comté, Dijon, France
| | - Abderrahmane Bourredjem
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France; CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Epidémiologie clinique/essais cliniques, Dijon, France
| | - Christine Binquet
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France; CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Epidémiologie clinique/essais cliniques, Dijon, France
| | - Claire Morisset
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France; CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France
| | - Anais Gouteron
- INSERM UMR 1093, Cognition, Action et Plasticité sensorimotrice, Dijon; Université de Bourgogne Franche Comté, Dijon, France.,Centre Hospitalier Universitaire Dijon-Bourgogne, service de médecine physique et réadaptation, Dijon, France
| | - Jean-Francis Maillefert
- Centre Hospitalier Universitaire Dijon-Bourgogne, Service de Rhumatologie, Dijon, France.,INSERM UMR 1093, Cognition, Action et Plasticité sensorimotrice, Dijon; Université de Bourgogne Franche Comté, Dijon, France
| | - Davy Laroche
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France; CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France.,INSERM UMR 1093, Cognition, Action et Plasticité sensorimotrice, Dijon; Université de Bourgogne Franche Comté, Dijon, France
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Ramon A, Schmitt M, Ne R, Maillefert JF, Ornetti P. Reply to: Diagnostic accuracy of dual energy computed tomography and joint aspiration: a prospective study in patients with suspected gouty arthritis. Clin Exp Rheumatol 2019; 37 Suppl 122:15-16. [PMID: 31573473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 03/07/2019] [Indexed: 06/10/2023]
Affiliation(s)
- André Ramon
- Rheumatology Department, Dijon University Hospital, France.
| | - Marie Schmitt
- Rheumatology Department, Dijon University Hospital, France
| | - Romaric Ne
- Radiology Department, Dijon University Hospital, France
| | | | - Paul Ornetti
- Rheumatology Department, Dijon University Hospital, France
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Pageaux B, Besson D, Casillas JM, Lepers R, Gremeaux V, Ornetti P, Gouteron A, Laroche D. Progressively increasing the intensity of eccentric cycling over four training sessions: A feasibility study in coronary heart disease patients. Ann Phys Rehabil Med 2019; 63:241-244. [PMID: 31669160 DOI: 10.1016/j.rehab.2019.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/17/2019] [Accepted: 09/26/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Benjamin Pageaux
- Inserm UMR1093-CAPS, UFR des sciences du sport, université Bourgogne Franche-Comté, 21000 Dijon, France; École de kinésiologie et des sciences de l'activité physique (EKSAP), faculté de médecine, université de Montréal, H3T 1J4 Montréal, Québec, Canada; Centre de recherche de l'institut universitaire de gériatrie de Montréal (CRIUGM), H3W 1W5 Montréal, Québec, Canada
| | - Delphine Besson
- Inserm, CIC 1432, module plurithematique, plateforme d'investigation technologique, 21078 Dijon, France; Centre d'investigation clinique, module plurithématique, plateforme d'investigation technologique, CHU Dijon-Bourgogne, 21078 Dijon, France
| | - Jean-Marie Casillas
- Inserm UMR1093-CAPS, UFR des sciences du sport, université Bourgogne Franche-Comté, 21000 Dijon, France; Inserm, CIC 1432, module plurithematique, plateforme d'investigation technologique, 21078 Dijon, France; Centre d'investigation clinique, module plurithématique, plateforme d'investigation technologique, CHU Dijon-Bourgogne, 21078 Dijon, France; Pôle de rééducation-réadaptation, CHU de Dijon, 21078 Dijon, France
| | - Romuald Lepers
- Inserm UMR1093-CAPS, UFR des sciences du sport, université Bourgogne Franche-Comté, 21000 Dijon, France
| | - Vincent Gremeaux
- Institute of Sport Sciences of University of Lausanne (ISSUL), CH-1015 Lausanne, Switzerland; Swiss Olympic Medical Center, Sport Medicine Unit, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
| | - Paul Ornetti
- Inserm UMR1093-CAPS, UFR des sciences du sport, université Bourgogne Franche-Comté, 21000 Dijon, France; Inserm, CIC 1432, module plurithematique, plateforme d'investigation technologique, 21078 Dijon, France; Centre d'investigation clinique, module plurithématique, plateforme d'investigation technologique, CHU Dijon-Bourgogne, 21078 Dijon, France; Département de rhumatologie, CHU de Dijon, 21078 Dijon, France
| | - Anais Gouteron
- Inserm UMR1093-CAPS, UFR des sciences du sport, université Bourgogne Franche-Comté, 21000 Dijon, France; Pôle de rééducation-réadaptation, CHU de Dijon, 21078 Dijon, France
| | - Davy Laroche
- Inserm UMR1093-CAPS, UFR des sciences du sport, université Bourgogne Franche-Comté, 21000 Dijon, France; Inserm, CIC 1432, module plurithematique, plateforme d'investigation technologique, 21078 Dijon, France; Centre d'investigation clinique, module plurithématique, plateforme d'investigation technologique, CHU Dijon-Bourgogne, 21078 Dijon, France.
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Gueugnon M, Stapley PJ, Gouteron A, Lecland C, Morisset C, Casillas JM, Ornetti P, Laroche D. Age-Related Adaptations of Lower Limb Intersegmental Coordination During Walking. Front Bioeng Biotechnol 2019; 7:173. [PMID: 31380364 PMCID: PMC6652268 DOI: 10.3389/fbioe.2019.00173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/04/2019] [Indexed: 01/04/2023] Open
Abstract
Lower-limb intersegmental coordination is a complex component of human walking. Aging may result in impairments of motor control and coordination contributing to the decline in mobility inducing loss of autonomy. Investigating intersegmental coordination could therefore provide insights into age-related changes in neuromuscular control of gait. However, it is unknown whether the age-related declines in gait performance relates to intersegmental coordination. The aim of this study was to evaluate the impact of aging on the coordination of lower limb kinematics and kinetics during walking at a conformable speed. We then assessed the body kinematics and kinetics from gait analyses of 84 volunteers from 25 to 85 years old when walking was performed at their self-selected speeds. Principal Component Analysis (PCA) was used to assess lower-limb intersegmental coordination and to evaluate the planar covariation of the Shank-Thigh and Foot-Shank segments. Ankle and knee stiffness were also estimated. Age-related effects on planar covariation parameters was evaluated using multiple linear regressions (i.e., without a priori age group determination) adjusted to normalized self-selected gait velocity. Colinearity between parameters was assessed using a variation inflation factor (VIF) and those with a VIF < 5 were entered in the analysis. Normalized gait velocity significantly decreased with aging (r = −0.24; P = 0.028). Planar covariation of inter-segmental coordination was consistent across age (99.3 ± 0.24% of explained variance of PCA). Significant relationships were found between age and intersegmental foot-shank coordination, range of motion of the ankle, maximal power of the knee, and the ankle. Lower-limb coordination was modified with age, particularly the coordination between foot, and shank. Such modifications may influence the ankle motion and thus, ankle power. This observation may explain the decrease in the ankle plantar flexor strength mainly reported in the literature. We therefore hypothesize that this modification of coordination constitutes a neuromuscular adaptation of gait control accompanying a loss of ankle strength and amplitude by increasing the knee power in order to maintain gait efficiency. We propose that foot-shank coordination might represent a valid outcome measure to estimate the efficacy of rehabilitative strategies and to evaluate their efficiency in restoring lower-limb synergies during walking.
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Affiliation(s)
- Mathieu Gueugnon
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France
| | - Paul J Stapley
- Neural Control of Movement Laboratory, Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Anais Gouteron
- CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France.,INSERM, UMR 1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du sport, Dijon, France.,Department of Physical Medicine and Rehabilitation, Dijon-Bourgogne University Hospital, Dijon, France
| | | | - Claire Morisset
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France
| | - Jean-Marie Casillas
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France.,INSERM, UMR 1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du sport, Dijon, France.,Department of Physical Medicine and Rehabilitation, Dijon-Bourgogne University Hospital, Dijon, France
| | - Paul Ornetti
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France.,INSERM, UMR 1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du sport, Dijon, France.,Department of Rheumatology, Dijon University Hospital, Dijon, France
| | - Davy Laroche
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, France.,INSERM, UMR 1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du sport, Dijon, France
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Ghesquiere T, Greigert H, Audia S, Devilliers H, Bielefeld P, Vernier N, Maurier F, Ornetti P, Gabrielle P, Martin L, Bonnotte B, Samson M. Étude des lymphocytes T invariants au cours de l’artérite à cellules géantes. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Martz P, Bourredjem A, Maillefert JF, Binquet C, Baulot E, Ornetti P, Laroche D. Influence of body mass index on sagittal hip range of motion and gait speed recovery six months after total hip arthroplasty. Int Orthop 2019; 43:2447-2455. [PMID: 30612173 DOI: 10.1007/s00264-018-4250-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/25/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE In practice, obesity leads to poor functional outcomes after total hip arthroplasty (THA). However, in clinical research, the influence of body mass index (BMI) on the gait recovery and kinematics for THA is not well documented. The purpose of this study was to assess the influence of BMI on gait parameters pre-operatively and six months after THA for hip osteoarthritis (OA) patients. METHODS We included 76 THA for hip OA: non-obese group (G1): 49 (BMI < 30 kg/2) and obese group (G2): 37 (BMI ≥ 30 kg/m2) with a control group of 61 healthy people. Clinical evaluation (HOOS) and a 3D gait analysis (gait speed and flexion range of the hip (ROM)) were performed before and six months after THA: The gains between the two visits were calculated and we looked for correlations between outcomes and BMI. RESULTS Preoperative gait speed and hip ROM were significantly lower in obese patients (speed G1: 0.81 ± 0.22 m/s vs. G2: 0.64 ± 0.23 m/s, p = 0.004 and hip ROM G1: 26.1° ± 7.3 vs. G2: 21.4° ± 6.6, p = 0.005), and obese patients were more symptomatic. At six months, gait speed and hip ROM were significantly lower for all patients compared with the control group. No correlation between gait velocity, hip ROM, and BMI was found. Biomechanical and clinical gains were comparable in the two groups. CONCLUSIONS All patients, including obese patients, have significant functional improvement after THA, objectively assessed by gait speed. Even if patients did not fully recover to the level of a healthy control person after THA, functional gain is comparable irrespective of BMI.
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Affiliation(s)
- Pierre Martz
- Department of Orthopaedic Surgery, CHU Dijon Bourgogne, F-21000, Dijon, France.
- INSERM UMR1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences de Santé, F-21000, Dijon, France.
| | - Abderrahmane Bourredjem
- INSERM CIC1432, Clinical Investigation Centre, Clinical Epidemiology Unit, F-21000, Dijon, France
| | - Jean Francis Maillefert
- INSERM UMR1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences de Santé, F-21000, Dijon, France
- INSERM CIC1432, Clinical Investigation Centre, Clinical Epidemiology Unit, F-21000, Dijon, France
| | - Christine Binquet
- INSERM CIC1432, Clinical Investigation Centre, Clinical Epidemiology Unit, F-21000, Dijon, France
| | - Emmanuel Baulot
- Department of Orthopaedic Surgery, CHU Dijon Bourgogne, F-21000, Dijon, France
- INSERM UMR1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences de Santé, F-21000, Dijon, France
| | - Paul Ornetti
- INSERM UMR1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences de Santé, F-21000, Dijon, France
- Department of Rheumatology, CHU Dijon Bourgogne, F-21000, Dijon, France
- INSERM CIC1432, Plurithematic Unit, Technologic Investigation Platform, F-21000, Dijon, France
| | - Davy Laroche
- INSERM CIC1432, Plurithematic Unit, Technologic Investigation Platform, F-21000, Dijon, France
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Affiliation(s)
- André Ramon
- Department of Rheumatology, Dijon University Hospital, Dijon, France
| | - Pierre Pottecher
- Department of Radiology, Section of Musculoskeletal Imaging and Intervention, Dijon University Hospital, Dijon, France.,LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, Dijon, France
| | - Paul Ornetti
- Department of Rheumatology, Dijon University Hospital, Dijon, France.,INSERM 1093 CAPS, University of Burgundy, Dijon, France
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Benguella L, Arbault A, Fillion A, Blot M, Piroth C, Denimal D, Duvillard L, Ornetti P, Chavanet P, Maillefert JF, Piroth L. Vitamin D supplementation, bone turnover, and inflammation in HIV-infected patients. Med Mal Infect 2018; 48:449-456. [PMID: 29661598 DOI: 10.1016/j.medmal.2018.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 02/27/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess whether vitamin D supplementation could be associated with a modification of inflammatory markers and bone turnover in HIV-1-infected patients. PATIENTS AND METHODS Patients who participated in an initial survey in 2010 and who were followed in the same department were included in a new study in 2012. Between 2010 and 2012, vitamin D supplementation was offered to patients presenting with hypovitaminosis D as per appropriate guidelines. Clinical examinations were performed, and fasting blood samples were taken for inflammation and bone marker evaluations. RESULTS Of the 263 patients who participated in the 2010 study, 198 were included in the 2012 study. Hypovitaminosis D was observed in 47% (36/77) of participants supplemented as per appropriate guidelines, in 78% (75/97) of transiently or incompletely supplemented participants, and in 71% (17/24) of non-supplemented participants (mainly because vitamin D levels in 2010 were normal). No significant correlation between vitamin D supplementation and the 2-year inflammation outcome (IL-6 and hsCRP) or C-terminal telopeptide levels was observed. However, a decrease in IL6 levels over the 2 years significantly correlated with reaching a normal vitamin D level (OR=0.89 per+1pg/mL IL6 increase, 95% CI=0.81-0.97, P=0.015). CONCLUSIONS Vitamin D supplementation decreases the risk of hypovitaminosis D but does not decrease the risk of inflammation nor bone turnover, unless normal 25-OH vitamin D levels are reached.
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Affiliation(s)
- L Benguella
- Département d'infectiologie, CHU de Dijon, 21079 Dijon, France; Service de Rhumatologie, CHU de Dijon, 21079 Dijon, France
| | - A Arbault
- Département d'infectiologie, CHU de Dijon, 21079 Dijon, France; Service de Rhumatologie, CHU de Dijon, 21079 Dijon, France
| | - A Fillion
- Département d'infectiologie, CHU de Dijon, 21079 Dijon, France
| | - M Blot
- Département d'infectiologie, CHU de Dijon, 21079 Dijon, France
| | - C Piroth
- Service de Rhumatologie, CHU de Dijon, 21079 Dijon, France
| | - D Denimal
- UMR U866, département de biochimie, université de Bourgogne, 21079 Dijon, France
| | - L Duvillard
- UMR U866, département de biochimie, université de Bourgogne, 21079 Dijon, France
| | - P Ornetti
- Service de Rhumatologie, CHU de Dijon, 21079 Dijon, France; Inserm U1093, université de Bourgogne, 21079 Dijon, France
| | - P Chavanet
- Département d'infectiologie, CHU de Dijon, 21079 Dijon, France; Inserm CIC 1432, université de Bourgogne, 21079 Dijon, France
| | - J-F Maillefert
- Service de Rhumatologie, CHU de Dijon, 21079 Dijon, France; Inserm U1093, université de Bourgogne, 21079 Dijon, France
| | - L Piroth
- Département d'infectiologie, CHU de Dijon, 21079 Dijon, France; Inserm CIC 1432, université de Bourgogne, 21079 Dijon, France.
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Affiliation(s)
- Pierre Pottecher
- Department of Radiology, LE2I UMR CNRS 6306, François-Mitterrand Teaching Hospital
| | - Pierre Martz
- Department of Orthopaedic Surgery, François-Mitterrand Teaching Hospital and INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté
| | - Paul Ornetti
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, and Department of Rheumatology, François-Mitterrand Teaching Hospital, Dijon, France
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Ramon A, Bohm-Sigrand A, Pottecher P, Richette P, Maillefert JF, Devilliers H, Ornetti P. Role of dual-energy CT in the diagnosis and follow-up of gout: systematic analysis of the literature. Clin Rheumatol 2018; 37:587-595. [PMID: 29350330 DOI: 10.1007/s10067-017-3976-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/28/2017] [Accepted: 12/29/2017] [Indexed: 12/27/2022]
Abstract
The aim of this systematic review was to determine the potential role of dual-energy CT in the diagnosis and follow-up of gout with regard to the Outcome Measures in Rheumatology (OMERACT) filter. A systematic analysis of the literature was conducted using the MEDLINE and Cochrane databases and published abstracts of international congresses, according to the criteria of the OMERACT filter: feasibility, reproducibility, validity versus laboratory (serum urate, MSU synovial fluid aspirate) and other imaging modalities for gout, and its sensitivity to change in patients on urate lowering therapy (ULT). Thirty-two articles were found representing a total of 1502 patients. The data on feasibility showed that the examination took little time and involved low levels of radiation but had current limited availability. Intra- and inter-observer reproducibility was excellent, with intra-class correlation coefficients > 0.9. Validity in comparison with polarized-light microscopy showed good sensitivity and specificity (> 80%). The diagnostic performance was better than that of radiography and conventional CT-scan and at least equivalent to that of ultrasonography. The sensitivity to change varied with effect sizes from 0.05 (low) to 1.24 (high) for decrease in the tophus volume following different ULT in gout patients. Dual-energy CT-scan is a reproducible and accurate imaging modality for the diagnosis of gout, particularly for tophaceous gout (intra- or extra-articular). It can become a second-line imaging modality of choice in cases of diagnostic doubt, such as ultrasonography. Its role remains uncertain in the follow-up of gout patients treated with ULT and needs further clarification.
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Affiliation(s)
- André Ramon
- Department of Rheumatology, Dijon University Hospital, 14 rue Gaffarel, 21000, Dijon, France
| | - Amélie Bohm-Sigrand
- Department of Rheumatology, Dijon University Hospital, 14 rue Gaffarel, 21000, Dijon, France
| | - Pierre Pottecher
- Department of Radiology, Section of Musculoskeletal Imaging and Intervention, Dijon University Hospital, Dijon, France
- LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, Dijon, France
| | - Pascal Richette
- INSERM U1132 and University Paris-Diderot, Paris, France
- Department of Rheumatology, Hopital Lariboisiere, Paris, France
| | - Jean-Francis Maillefert
- Department of Rheumatology, Dijon University Hospital, 14 rue Gaffarel, 21000, Dijon, France
- INSERM UMR1093-CAPS, Bourgogne Franche-Comté University, Dijon, France
| | - Herve Devilliers
- Department of Internal Medicine, Dijon University Hospital, Dijon, France
- CIC INSERM 1432, Centre Hospitalier Universitaire de Dijon, F-21000, Dijon, France
| | - Paul Ornetti
- Department of Rheumatology, Dijon University Hospital, 14 rue Gaffarel, 21000, Dijon, France.
- INSERM UMR1093-CAPS, Bourgogne Franche-Comté University, Dijon, France.
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Bohm-Sigrand A, Pottecher P, Ornetti P. Burned to the Bone. J Rheumatol 2017; 44:1507-1508. [PMID: 28966169 DOI: 10.3899/jrheum.161388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Pierre Pottecher
- Department of Radiology, Section of Musculoskeletal Imaging and Intervention, LE2I UMR CNRS 6306, University of Burgundy, François-Mitterrand Teaching Hospital
| | - Paul Ornetti
- Department of Rheumatology, INSERM 1093, University of Burgundy, François-Mitterrand Teaching Hospital, Dijon Cedex, France.
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Devilliers H, Leong K, Bourredjem A, Machu J, Arnaud L, Ornetti P, Amoura Z. Invariance culturelle du questionnaire de qualité de vie spécifique SLEQOL dans le lupus systémique : comparaison des résultats des patients issus des cohortes française et de Singapour. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Naaim A, Morisset C, Ornetti P, Laroche D. In response to the article published by Fukaya et al., entitled: "Relationships between the center of pressure and the movements of the ankle and knee joints during the stance phase in patients with severe medial knee osteoarthritis". Knee 2017; 24:482-483. [PMID: 27955812 DOI: 10.1016/j.knee.2016.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/05/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Alexandre Naaim
- CIC-P INSERM 1432, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon F-21078, France
| | - Claire Morisset
- CIC-P INSERM 1432, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon F-21078, France
| | - Paul Ornetti
- INSERM U1093, Dijon F-21079, France; Department of Rheumatology, Dijon University Hospital, Dijon F-21078, France; University of Burgundy, Dijon F-21079, France
| | - Davy Laroche
- CIC-P INSERM 1432, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon F-21078, France; INSERM U1093, Dijon F-21079, France.
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Arbault A, Ornetti P, Laroche D, Pottecher P. Osteitis fibrosa cystica. Joint Bone Spine 2017; 84:229. [DOI: 10.1016/j.jbspin.2016.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/09/2016] [Indexed: 11/28/2022]
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