Paget’s disease in Senegal : two cases of a rare disease in black african populations
Journal Title: Batna Journal of Medical Sciences (BJMS) - Year 2016, Vol 3, Issue 2
Abstract
Mr. MD is a 72-years-old man, admitted for spontaneous, permanent, crushing type pain on the pelvis above the right hip evolving for two years, without night or morning stiffness but increasing with hearing loss, temporal and parietal headache. Physical examination showed a painful hip in active and passive mobilization. Pressure on iliac spines and lower lumbar and sacrococcygeal bones was painful. The patient showed no inflammatory syndrome. Serum calcium was normal. We noted an isolated increase in alkaline phosphatase levels to 401 IU/l. Radiographs showed bilateral heterogeneous sclerosis of the iliac bone with thickening lines and almost disappearance of the right hip joint space. There was a marked thickening of the cortex on the femoral proximal third and thickening of the cranial vault. MRI showed cortical thickening of the right pelvic bone, a T1 hyper signal, and an intermediate T2 signal with fat/sat. This was pathognomonic of Paget's disease. The second patient is a 72-year-old man with no history, having intense pain on the right side of the lower limb. Physical examination showed no musculoskeletal deformity, but pain on palpation and mobilization of the right hip. Serum alkaline phosphatase (ALP) was raised to 4 times the normal range. Radiography showed cortical thickening of the ischial pubic branch, a heterogeneous sclerosis gypsy moth of the iliac wing, a steady narrowing of the femoral hip-spaced lines and thickening of the iliac ischial pubic. This aspect is pathognomonic of Paget’s disease, the patient underwent treatment with zoledronic acid intravenously at 5 mg. The outcome was favorable up to 10 months with reduced pain (VAS = 2/10) and normal PAL.
Authors and Affiliations
Ismaïla Diédhiou, Awa-Ndao Fall, Thierno-Oumar Soko, Abdou-Rajack Ndiaye.
Keywords
Related Articles
- EP ID EP680490
- DOI -
- Views 143
- Downloads 0
COVID-19 : épidémiologie et physiopathologie
COVID-19 is an acute pandemic infectious disease caused by a novel coronavirus (SARS-Cov-2) first detected in China in December 2019. Transmission occurs primarily through the respiratory route. The reproduction rate (...
Peau et soleil
Le soleil émet une multitude de rayonnements électromagnétiques filtrés par l’atmosphère terrestre. Arrivant à la surface de la planète, ces rayonnements sont indispensables pour l'installation et le développement de la...
La génétique et l’épigénétique au service des maladies rénales
La maladie rénale chronique augmente le risque de morbi-mortalité. Le diagnostic est aisé mais rétrospectif, les facteurs de risques sont codifiés et ainsi que les principales cibles thérapeutiques. L’épigénome, interfac...
La prescription ambulatoire des psychotropes à l’hôpital psychiatrique El Madher Batna : étude transversale sur trois mois
Objectifs : Décrire et analyser les modalités de prescription de psychotropes chez des patients suivis en ambulatoire à l’hôpital psychiatrique. Méthodes : Etude descriptive transversale sur la prescription de psychotrop...
Kyste hydatique du septum interventriculaire : à propos d’un cas
Introduction. La localisation cardiaque de la maladie hydatique est rare (< 3%) même dans les pays endémiques. C’est une affection caractérisée par une longue tolérance fonctionnelle et un grand polymorphisme clinique et...