Profil Des Infections Ostéoarticulaires En Consultation Rhumatologique Au CHU- Kara (Togo)

Introduction: Osteoarticular infections remain public health problems in Africa. We aim at determining the clinical forms, topographic and etiological osteoarticular infections in a rheumatology unit of northern Togo. Methods: We conducted a cross-sectional study from April 2012 to March 2015 on inpatient records having suffered from musculoskeletal infection. Results: Of the 1813 patients admitted to the department in three years, 86 (4.74%) suffered from musculoskeletal infection. Of them, 36 (41.86%) were men and 50 (58.1% 4) were women, with a sex ratio (M/F) of 0.72. The mean age of the patients was 45 years. The mean duration of disease progression was 3.5 months. The different clinical forms observed were: spondylitis (47 patients, 54.65%), infectious arthritis (31 cases, 36.05%) and osteomyelitis (eight cases; 9.30%). The infection was likely tuberculous in 53 patients (61.63%), including 44 cases of Pott's disease. A banal germ was mentioned in the 33 others patients (38.37%). In four cases, the germ was isolated: Staphylococcus aureus (three cases) and Staphylococcus epidermidis (one case). The joints most affected by the infection were the hip (nine patients) and the knee (eight patients). Infection was multifocal in 14 cases (16.27%). The main risk factors for the infection identified were: promiscuity and poor hygiene (59.30%), alcoholism (26.74%) and retroviral infection (12.79%). Conclusion: This study and joint infections are a common reason for rheumatology consultation in northern Togo with a significant share of multifocal forms

Prise En Charge Infirmière De La Douleur Chez L’adulte Au CHU-Kara (Togo)

Introduction: Pain is a frequent reason for consultation in health facilities. Thus, nurses are in the forefront in the fight against pain. The aim of this study was to determine the role of the nurse in the management of the painful adult patient. Methodology: It was a cross-sectional study conducted in 11 departments of Kara teaching hospital during two weeks. Nurses who had managed a painful adult in the past seven days were included in the study. Results: Thirty nurses participated in the study. They were made of 24 men (76.67%) and six women (23.33%). The average age of nurses was 35 years (extremes: 23 years old and 50 years old) and 43.33% of them had less than five years of work experience. The main etiologies of pain managed were: trauma (22%), headache (18%) and abdominal pain (14%). Pain assessment tools were almost non-existent. Fifty percent of nurses did not know pain assessment tools. The evaluation of pain was performed with conventional tools by 16% of nurses. The analogical visual scale was the most used (three out of five nurses). Nursing intervention was dominated by counseling (43%) and thermal stimulation (22%). The use of analgesics was carried out in 83.33% of cases. Conclusion: This study shows that few nurses evaluated the pain during its management in adults. Therefore, it is necessary to initiate medical training for Togolese nurses on the management of the painful patient in order to make them more effective

Prévalence De La Douleur Neuropathique Chez Des Patients Souffrant De Lomboradiculalgie Commune En Consultation Rhumatologique À Lomé (Togo)

Objective: To determine the prevalence and factors associated with neuropathic pain in patients with non-specific low back pain. Methods: This was a cross-sectional study conducted from May to July 2016 in the Rheumatology, Neurology and Neurosurgery departments of Lome. The DN4 questionnaire was used for the diagnosis of neuropathic pain in the 200 patients with low back pain included in this study. Results: Of the 200 patients (147 women and 53 men) included in the study, neuropathic pain was present in 92 (46%). The average age of the 92 patients (67 women vs 25 men, p = 0.04) was 55.5 ± 12.4 years (women 55.2 ± 12.8 vs. men 54.6 ± 11.4, p = 0.5). The characteristics of neuropathic pain mainly found were: burning sensation (n = 67, 72.8%); electrical discharges (n = 64, 69.6%); tingling (n = 90; 97.8%); tickling (n = 57; 62%); numbness (n = 89; 96.7%); hypoesthesia (n = 52; 56.5%). Factors significantly associated with the presence of neuropathic pain in LBP were age (p = 0.005), duration of LBP (p = 0.04), high blood pressure (p = 0.001), radicular pain (p = 0.00002) and the past history of the LBP (0.000000). Conclusion: Neuropathic pain is common in patients with LBP at Lome. The duration of LBP, past history of LBP, previous NSAID use, BMI, pain severity and radicular pain appear to be predictive of the occurrence of these neuropathic pains

Profil de l’algodystrophie chez 112 patients en consultation rhumatologique à Lomé (Togo)

Objectives: To determine the frequency and semiological profile of Complex Regional Pain Syndrome (CRPS) in Lomé. Patients and methods: It was the study of a series of cases on files of patients suffering from CRPS and seen in 24 years of rheumatologic practice in Lomé. The diagnosis was mainly radioclinic. Results: 112 from the 22425 examined patients (0.5%) suffered from CRPS. These 112 patients were made of 71 women and 41 men ; and had the mean age of 53.07 years at the diagnosis. The median duration of the disease was 4.29 months. The main risk factors founded in 60 patients were: trauma (53.33%), stroke (23.32%) and diabetes (6.00%). In the 52 others patients, no risk factor was found. The CRPS was preferably located at shoulder (41 cases), and the wrist and hand (15 cases). Shoulder-hand syndrome was observed in 34 patients (30.63%). Inflammatory pain (59 patients) and mechanical pain (49 patients) were mostly observed. The mobilization of the joints was painful in 110 cases. The pain was associated with joint stiffness (51 patients), locoregional swollen joint (39 patients) and cutaneous disorders (15 patients). Among the 52 patients seen in control, the outcome was favorable in 49 cases and a recidivism in three cases. Conclusion: The cases of CRPS observed in Black Africa do not present particularity on semiological and demographic features

Panorama of Inflammatory Arthropathies in Rheumatologic Consultation in Northen-Togo

International audienc

Epiphyseal Necrosis in Patients with HIV Infection and Free from Sickle Cell Disease

International audienc

Lymphome osseux primitif multifocal révélé par une fièvre au long cours : A propos d’un cas : Primary multifocal bone lymphoma revealed by long-term fever: A case report

Non-Hodgkin’s lymphoma (NHL) is a malignant clonal proliferation of lymphoid tissue; they represent the majority of lymphomas. NHL mainly affects the lymph nodes, but they can develop in all organs. Primary bone NHL is rare and multifocal localization remains exceptional. We report the observation of a patient with multifocal primary bone lymphoma (PBL) with localization in the spine, collarbone and pelvis. Les lymphomes non hodgkiniens (LNH) representant la majorité des lymphomes sont des proliférations clonales malignes du tissu lymphoïde. Les LNH affectent surtout les ganglions lymphatiques mais ils peuvent se développer dans tous les organes. Les LNH osseux primitifs sont rares et la localisation multifocale reste exceptionnelle. Nous rapportons l’observation d’un patient qui présente un lymphome osseux primitif (LOP) multifocal avec une localisation au rachis, à la clavicule et au bassin