Plasmocytome fémoral révélant un myélome multiple des os : à propos d’un cas: Femoral plasmocytoma revealing a multiple myeloma: a case report

Plasmacytoma is a rare clonal proliferation of tumor plasma cells, localized to a segment bone or with multiple myeloma. The extra-spinal bone localization has never been described in sub-Saharan Africa. We report the case of a femoral plasmocytoma revealing multiple bone myeloma in a 53-year-old woman. Le plasmocytome est une prolifération plasmocytaire monoclonale, localisée à un segment osseux ou accompagnée d’un myélome multiple. Cette affection est rare et une localisation osseuse extra-rachidienne n’a jamais été décrite en Afrique sub-saharienne. Les auteurs rapportent le cas d’un plasmocytome fémoral révélant un myélome multiple des os chez une femme de 53 ans. &nbsp

Profil des Maladies Rhumatismales du Sujet Age en Guinee

Aim: To determine the respective share of the different rheumatic conditions observed in the elderly person who was hospitalized in the rheumatology department of the CHU Ignace Deen. Patients and methods: This was a cross-sectional study of patients aged 60 or aver seen in consultation or hospitalized in the rheumatology department during the period from October 2016 to April 2018. Rheumatic diseases have been diagnosed according to the criteria. Results: 1502 patients were examined during the study period; there were 521 patients aged ago 60 years and overs; of whom 351(23, 36%) had at least one rheumatologic diagnostic. There was a predominance of women (216; 61, 54%). The average age of diagnostic were 67, 63 ± 6, 71 years (extremes de 60 to 93 years). The average delay in diagnostic was 3, 91 ± 4, 21 years (extremes de 1 month to 51 years). High blood pressure (142; 40,45%) and diabetes (40; 11,39%) were the main comorbidities. Degenerative pathology (295; 84, 04%) was the most common with low pain (112; 31,90%) as a leader. There were 45 cases (12,82%) of chronic inflammatory rheumatism; rheumatoid arthritis (19; 5,41%) was the most common, followed by spondyloartritis (8; 2,27%). Osteopathies (36 ; 10,25%); periarticular and syndromes (20 ; 5,69%), microcristal arthropathies (24 ; 6,83%), infectious pathology (8; 2,27%) and tumoral pathology (9; 2,56%)were the other diseases found. Conclusion: Degenerative pathology and chronic inflammatory rheumatism were the most common. The expected balance of sex ratio in RA at this age was rather in favor of female predominance. Prospective cohort studies would provide a better understanding of this question.Objectifs: Déterminer le profil épidémiologique des maladies rhumatismales des personnes âgées au service de rhumatologie de l’hôpital National Ignace Deen de Conakry. Patients et méthodes: Il s'est agi d'une étude transversale portant sur des patients âgés d'au moins 60 ans vus en consultation ou hospitalisés dans le service de rhumatologie pendant la période d’octobre 2016 à Avril 2018. Les maladies rhumatismales ont été diagnostiquées selon les critères en vigueur. Résultats: Des 1502 malades examinés, 351 (23,36%) étaient âgés d’au moins 60 ans. Il y avait une prédominance féminine (216 ; 61,54%). L’âge moyen était de 67,63 ± 6,71 ans (extrêmes de 60 et 93 ans). Le délai moyen de diagnostic était de 3,91 ± 4,21 ans (extrêmes de 1 mois et 51 ans). L’hypertension artérielle (142; 40,45%) et le diabète (40; 11,39%) étaient les principales comorbidités. La pathologie dégénérative (295 ; 84,04 %) était la plus fréquente avec une prédominance de la lombalgie commune (112; 31,90 %). Il y avait 45 cas (12,82%) de rhumatisme inflammatoire chronique : la polyarthrite rhumatoïde (PR) (19 cas ; 5,41%) était le plus fréquent, suivie des spondyloarthrites (8; 2,27%). Les ostéopathies (36 ; 10,25%), la pathologie péri-articulaire et les syndromes canalaires (20; 5,69%), les arthropathies microcristallines (24 ; 6,83%), la pathologie infectieuse (8 ; 2,27 %) et la pathologie tumorale (9 ; 2,56 %) étaient les autres maladies retrouvées. Conclusion: La pathologie dégénérative et les rhumatismes inflammatoires chroniques étaient les plus fréquents. L’équilibre attendu du sex-ratio dans la PR à cet âge était plutôt en faveur d’une prédominance féminine. Des études de cohortes prospectives permettraient de mieux comprendre cette question

Recours a la Médecine Traditionnelle chez les Rhumatisants en Guinée

Aim: To determine the frequency and pattern of use of traditional medicine in rheumatic patients at Ignace Deen National Hospital in Conakry, Guinea. Patients and methods: Descriptive cross-sectional study in the rheumatology department of HNID between January and March 2018 Results: Of the 108 patients interviewed, 40 had used traditional medicine (37.03%). There was a female predominance (21 women, 52.5%) with a sex ratio of 0.90. The mean age of the patients was 44.75 ± 17.24 years. Rheumatoid arthritis and knee osteoarthritis were the main rheumatic diseases observed with 41.86% and 16.27% respectively. The diagnostic delay was 6.54 ± 1.25 years. The nature of the treatment used was dominated by taking a decoction (57.50%) and the reason for using traditional treatment was to relieve pain (85%). The oral route was the main mode of use of traditional treatment (67.5%). More than half of the patients (52.50%) were not satisfied with the outcome of traditional treatment received and did not know the name of the treatment used in their vernacular language. In 47.50% of cases they thought that traditional treatment had adverse effects and had possible interactions with modern drug therapy. Conclusion: More than a third of rheumatology consulting patients use traditional medicine even though they believe it has side effects. This phenomenon leads to a delay in consultation with the rheumatologist, hence the need for better communication between the different actors.Objectif : Déterminer la fréquence et le profil de l’utilisation de la médecine traditionnelle chez les patients souffrant de rhumatisme à l'hôpital national Ignace Deen de Conakry (Guinée). Patients et méthodes : Etude transversale de type descriptif dans le service de rhumatologie de l'HNID entre janvier et mars 2018. Résultats : Sur 108 patients interrogés, 40 avaient eu recours à la médecine traditionnelle soit 37,03 %. On notait une prédominance féminine (21 femmes ; 52,5 %) avec un sexe ratio de 0,90 H/F. L’âge moyen des patients était de 44,75 ± 17,24 ans. La polyarthrite rhumatoïde et la gonarthrose étaient les principales affections rhumatologiques observées avec respectivement 41,86% et 16,27%. Le délai diagnostique était de 6,54 ±1,25 ans. La nature du traitement utilisé était dominée par la prise de décoction (57,50%) et le motif d’utilisation du traitement était de soulager la douleur (85%). La voie orale était le principal mode d’utilisation (67,5%). Plus de la moitié des patients (52,50%) n’étaient pas satisfaits du résultat du traitement traditionnel reçu et ne connaissaient pas le nom du traitement utilisé dans leur langue vernaculaire. Ils pensaient dans 47,50% des cas que le traitement traditionnel entrainait des effets indésirables et avait de possibles interactions avec le traitement médicamenteux moderne. Conclusion : Plus du tiers des patients consultant en rhumatologie ont recours à la médecine traditionnelle même s’ils croient qu’elle a des effets indésirables. Ce phénomène entraîne un retard à la consultation chez le rhumatologue, d’où la nécessité d’une meilleure communication entre les différents acteurs

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

Lomboradiculalgie Du Sujet Âgé En Consultation Rhumatologique À Lomé, Togo

Objective: To study the epidemiological, diagnostic, therapeutic and outcome aspects of low back pain with radicular pain in rheumatology ward at Sylvanus Olympio Teaching Hospital at Lome, TOGO. Methods: It is a cross sectional study of 298 patients of 65 years and above, suffering from low back pain with radicular pain. They were admitted in the rheumatology ward of Sylvanus Olympio Teaching Hospital from January 2010 to December 2015. Results: 298 out of 768 patients examined within a period of five years (38.80%) were suffering from low back pain with radicular pain. These 298 patients comprises of 215 women (72.15%) and 83 men (27.85%) with an average age of 62.04 years at the onset. The mean age at the consultation was 70.72 ± 5.5 years. The mean duration of the diseases was 10.28 ± 23.81 months. The major diseases observed were degenerative disc (279 cases : 93.61%), bone tumors (16 cases : 5.38%), and spondylodiscitis (03 cases : 1.01%). The clinical manifestations of the degenerative disc of the lumbar spine were the LBP (209 cases : 74,91%) European Scientific Journal October 2017 edition Vol.13, No.30 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 223 and the narrowed lumbar canal (47 cases : 16.85%). The bone tumors were dominated by prostate cancer (five cases : 12,02%). The spondylodiscitis, probably of tuberculous origin, affected three patients, among whom was one Human Immunodeficiency Virus (HIV) patient. Conclusion: Degenerative disc is a frequent pathology nowadays, both in the Togolese population and in the elderly in particular. Nevertheless, efforts should be made to eliminate specific back pain in the elderly, whose clinical picture may be misleading

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

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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