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المؤلفون: Géraldine Bart, Benoit Le Goff, Laurie Charret, Grégoire Cormier, David Boutoille, Emmanuelle Dernis, Christelle Darrieutort-Laffite, Emmanuel Hoppe
المصدر: Journal of Antimicrobial Chemotherapy. 76:3029-3032
مصطلحات موضوعية: Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Bursitis, medicine.drug_class, Olecranon, 030106 microbiology, Antibiotics, medicine.disease_cause, Septic bursitis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Antibiotic therapy, Elbow Joint, medicine, Humans, Pharmacology (medical), Olecranon Process, Pharmacology, 030222 orthopedics, Streptococcus, business.industry, Bacterial Infections, Middle Aged, medicine.disease, Comorbidity, Anti-Bacterial Agents, Infectious Diseases, medicine.anatomical_structure, Cellulitis, Female, business
الوصف: Background No current guidelines are available for managing septic bursitis (SB). Objectives To describe the clinical characteristics and management of olecranon and prepatellar SB in five French tertiary care centres. Methods This is a retrospective observational multicentre study. SB was diagnosed on the basis of positive cultures of bursal aspirate. In the absence of positive bursal fluid, the diagnosis came from typical clinical presentation, exclusion of other causes of bursitis and favourable response to antibiotic therapy. Results We included 272 patients (median age of 53 years, 85.3% male and 22.8% with at least one comorbidity). A microorganism was identified in 184 patients (67.6%), from bursal fluids in all but 4. We identified staphylococci in 135 samples (73.4%), streptococci in 35 (19%) and 10 (5.5%) were polymicrobial, while 43/223 bursal samples remained sterile (19.3%). Forty-nine patients (18%) were managed without bursal fluid analysis. Antibiotic treatment was initially administered IV in 41% and this route was preferred in case of fever (P = 0.003) or extensive cellulitis (P = 0.002). Seventy-one (26%) patients were treated surgically. A low failure rate was observed (n = 16/272, 5.9%) and failures were more frequent when the antibiotic therapy lasted Conclusions Despite variable treatments, SB resolved in the majority of cases even when the treatment was exclusively medical. The success rate was equivalent in the non-surgical and the surgical management groups. However, a treatment duration of
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dafaeae5cf13b4a9e6db087760bf84c9Test
https://doi.org/10.1093/jac/dkab265Test -
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المؤلفون: Robert Touitou, Géraldine Bart, Marion Couderc, E. Veillard, Pascal Guggenbuhl, P. Coquerelle, Sophie Godot, Christian Lormeau, Denis Mulleman, Guillaume Coiffier, Carine Salliot, Marion Baldeyrou, Beate Hyem, Jean-Marc Ziza, Thomas W. Bauer, René-Marc Flipo, Christelle Darrieutort-Laffite, Raphaèle Seror, Bernard Fouquet, Louis Bernard
المساهمون: Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand
المصدر: Joint Bone Spine
Joint Bone Spine, 2020, 87 (6), pp.538-547. ⟨10.1016/j.jbspin.2020.07.012⟩
Joint Bone Spine, Elsevier Masson, 2020, 87 (6), pp.538-547. ⟨10.1016/j.jbspin.2020.07.012⟩مصطلحات موضوعية: Adult, Staphylococcus aureus, medicine.medical_specialty, medicine.drug_class, [SDV]Life Sciences [q-bio], Antibiotics, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Internal medicine, Humans, Medicine, Streptococcus gallolyticus, 030212 general & internal medicine, Medical diagnosis, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, Language, 030203 arthritis & rheumatology, Arthritis, Infectious, business.industry, Staphylococcal Infections, medicine.disease, Anti-Bacterial Agents, 3. Good health, Joint aspiration, Infective endocarditis, Septic arthritis, business, Trauma surgery
الوصف: Septic arthritis (SA) in an adult native joint is a rare condition but a diagnostic emergency due to the morbidity and mortality and the functional risk related to structural damage. Current management varies and the recommendations available are dated. The French Rheumatology Society (SFR) Bone and Joint Infection Working Group, together with the French Language Infectious Diseases Society (SPILF) and the French Orthopaedic and Trauma Surgery Society (SOFCOT) have worked according to the HAS methodology to devise clinical practice recommendations to diagnose and treat SA in an adult native joint. One new focus is on the importance of microbiological documentation (blood cultures and joint aspiration) before starting antibiotic treatment, looking for differential diagnoses (microcrystal detection), the relevance of a joint ultrasound to guide aspiration, and the indication to perform a reference X-ray. A cardiac ultrasound is indicated only in cases of SA involving Staphylococcus aureus, oral streptococci, Streptococcus gallolyticus or Enterococcus faecalis, or when infective endocarditis is clinically suspected. Regarding treatment, we stress the importance of medical and surgical collaboration. Antibiotic therapies (drugs and durations) are presented in the form of didactic tables according to the main bacteria in question (staphylococci, streptococci and gram-negative rods). Probabilistic antibiotic therapy should only be used for patients with serious symptoms. Lastly, non-drug treatments such as joint drainage and early physical therapy are the subject of specific recommendations.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e9308e225fae67b0cbfb68fa506305f5Test
https://doi.org/10.1016/j.jbspin.2020.07.012Test -
3
المؤلفون: Claire Bernier, Hélène Aubert, Jean-Marie Berthelot, Antoine Néel, Christian Agard, Sébastien Barbarot, Benoit Le Goff, Mohamed Hamidou, Agathe Masseau, Françoise Kraeber-Bodéré, Christelle Darrieutort-Laffite, Catherine Ansquer
المصدر: Arthritis Research & Therapy, Vol 22, Iss 1, Pp 1-10 (2020)
Arthritis Research & Therapyمصطلحات موضوعية: Male, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Interleukin 1 receptor antagonist, Single Center, Cohort Studies, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Schnitzler syndrome, Musculoskeletal Pain, Internal medicine, medicine, Humans, Bone pain, Retrospective Studies, business.industry, Waldenstrom macroglobulinemia, Retrospective cohort study, Bone scan, medicine.disease, Rash, Rheumatology, Bone lesions, Cohort, Female, medicine.symptom, lcsh:RC925-935, business, 030215 immunology, Research Article, Follow-Up Studies
الوصف: Objective To report on the characteristics and long-term course of rheumatic manifestations in Schnitzler syndrome (SchS). Methods A retrospective cohort study of patients with SchS followed between 2000 and 2020. Inclusion criteria included a diagnosis of SchS (Strasbourg criteria). All available bone scans were reviewed and scored according to the intensity and number of pathological sites. The scintigraphic score was compared with the clinical activity score, CRP level, and treatments. Results Twenty-five patients were included. Median age at diagnosis was 68 years. Eighty patients (72%) had SchS-related rheumatic pain. Most patients had a long-standing isolated rash before constitutional and/or rheumatic symptoms appeared. The monoclonal component level was usually very low (IgMκ in 22/25). Rheumatic pain predominated around the knees. Bone scans revealed abnormal tracer uptake in 15/18 (85%). The scintigraphic score correlated with clinical activity (r = 0.4, p r = 0.47, p p Conclusions Rheumatic manifestations are very prevalent in SchS. However, bone pain can be misleading and contribute to misdiagnosis. Bone scan abnormalities are very prevalent and correlate with disease activity and treatments. IL1-Ra has a dramatic and durable efficacy but may not be required in every patient early on.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::52bd4540be4dcd843b01445f9f1276c5Test
http://link.springer.com/article/10.1186/s13075-020-02318-5Test -
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المصدر: Frontiers in Medicine
Frontiers in Medicine, Vol 8 (2021)مصطلحات موضوعية: medicine.medical_specialty, Medicine (General), diagnosis, Context (language use), Stimulus (physiology), psyche, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, R5-920, hypersensitisation, Fibromyalgia, medicine, Chronic fatigue syndrome, pain, Restless legs syndrome, 030203 arthritis & rheumatology, business.industry, Cognitive disorder, Chronic pain, Chronic fatigue, General Medicine, medicine.disease, neuro-imaging, Perspective, Medicine, fibromyalgia, fatigue, business, 030217 neurology & neurosurgery
الوصف: The concept of fibromyalgia has progressed to achieve a certain consensus regarding the definition of the condition. We summarize what is known in 2020, be it in terms of diagnosis, with the criteria that have changed over the years, or at the level of the psychological profile, via the notions of “catastrophizing” and “coping” and post-traumatic syndrome. The importance of fatigue and sleep disorders is underlined, with the chronological sequence of post-traumatic syndrome, chronic fatigue, and then amplification of the pain and the onset of multiple associated symptoms. The etiopathogenic debate has been enriched thanks to neuro-imaging data to discover the start of the central neurological signature. The many associated symptoms are reanalyzed in the context of so-called sister conditions which form sometimes more or less separate entities, such as chronic fatigue syndrome or restless legs syndrome for example. What these conditions have in common is hypersensitivity, not just to pain, but also to all exteroceptive stimuli, from deep sensitivity in the neuro-vegetative system, the sense organs and certain functions of the central nervous system, to the psychological aspects and sleep control. In summary, it is possible to define fibromyalgia as a cognitive disorder of cortical integration of chronic pain, with amplification of painful and sensory nociception, decrease in the threshold for the perception of pain, and persistence of a stimulus that maintains the process in chronicity. Fibromyalgia is part of a group of chronic hypersensitivity syndromes of central origin, with a very wide range of means of expression.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::04cf44b17490b63a226cb30e3f2278eeTest
http://europepmc.org/articles/PMC8316633Test -
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المؤلفون: Benoit Le Goff, Jean-David Albert, Nicolas Dumoulin, Guillaume Coiffier, Grégoire Cormier, Stéphane Varin, Christelle Darrieutort-Laffite
المصدر: The American journal of sports medicine. 49(4)
مصطلحات موضوعية: medicine.medical_specialty, Percutaneous, Physical Therapy, Sports Therapy and Rehabilitation, law.invention, 03 medical and health sciences, Rotator Cuff, 0302 clinical medicine, Randomized controlled trial, law, Shoulder Pain, Post-hoc analysis, medicine, Effective treatment, Humans, Orthopedics and Sports Medicine, Rotator cuff, Calcific tendinopathy, Therapeutic Irrigation, Ultrasonography, Interventional, 030203 arthritis & rheumatology, 030222 orthopedics, business.industry, Calcific tendinitis, medicine.disease, Ultrasound guided, Surgery, medicine.anatomical_structure, Treatment Outcome, Case-Control Studies, Tendinopathy, business
الوصف: Background: Calcific tendinitis of the rotator cuff is a frequent cause of shoulder pain. Ultrasound-guided percutaneous lavage (UGPL) is an effective treatment, but factors associated with good clinical and radiological outcomes still need to be identified. Purpose: To study the clinical, procedural, and radiological characteristics associated with improved shoulder function and the disappearance of calcification on radiograph after UGPL. Study Design: Case-control study; Level of evidence, 3. Methods: This is a post hoc analysis of the CALCECHO trial, a double-blinded randomized controlled trial conducted on 132 patients. The trial assessed the effect of corticosteroid injections after UGPL, and patients were randomly assigned to receive either corticosteroid or saline solution in the subacromial bursa. We analyzed all patients included in the randomized controlled trial as 1 cohort. We collected the patients’ clinical, procedural, and radiological characteristics at baseline and during follow-up (3, 6, and 12 months). Univariable analysis, followed by multivariable stepwise regression through forward elimination, was performed to identify the factors associated with clinical success (Disabilities of the Arm, Shoulder and Hand [DASH] score Results: Good clinical outcomes at 3 months were associated with steroid injections after the procedure (odd ratio [OR], 3.143; 95% CI, 1.105-8.94). At 6 months, good clinical evolution was associated with a lower DASH score at 3 months (OR, 0.92; 95% CI, 0.890-0.956) and calcium extraction (OR, 10.7; 95% CI, 1.791-63.927). A lower DASH at 6 months was also associated with a long-term favorable outcome at 12 months (OR, 0.939; 95% CI, 0.912-0.966). Disappearance of calcification at 3 and 12 months occurred more frequently in patients in whom communication was created between the calcification and the subacromial bursa during the procedure (OR, 2.728 [95% CI, 1.194-6.234] at 3 months; OR, 9.835 [95% CI, 1.977-48.931] at 12 months). Importantly, an association between calcification resorption and good clinical outcome was found at each time point. Conclusion: Assessing patients at 3 months seems to be an essential part of their management strategy. Calcium extraction and creating a communication between the calcific deposits and subacromial bursa are procedural characteristics associated with good clinical and radiological evolution.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e855bca0fe1586773a1e4c6ad4a64346Test
https://pubmed.ncbi.nlm.nih.gov/33719606Test -
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المؤلفون: Catherine Chevalier, Julien Herman, Frédéric Blanchard, Julien De Lima, Christelle Darrieutort-Laffite, Benoit Le Goff, Régis Brion
المصدر: Arthritis Research & Therapy, Vol 23, Iss 1, Pp 1-11 (2021)
Arthritis Research & Therapyمصطلحات موضوعية: 0301 basic medicine, Rotator cuff tendons, Pathology, medicine.medical_specialty, Myeloid, Inflammasomes, Interleukin-1beta, Inflammation, Diseases of the musculoskeletal system, Inflammasome, 03 medical and health sciences, 0302 clinical medicine, In vivo, Apatites, NLR Family, Pyrin Domain-Containing 3 Protein, medicine, Humans, Apatite, 030203 arthritis & rheumatology, Chemistry, Caspase 1, Air pouch model, Interleukin, medicine.disease, In vitro, 030104 developmental biology, medicine.anatomical_structure, RC925-935, Tendinopathy, Tumor necrosis factor alpha, medicine.symptom, Research Article, Interleukin-1, medicine.drug, Calcification
الوصف: Background Calcific tendonitis of the rotator cuff is due to carbonated apatite deposits in the shoulder tendons. During the evolution of the disease, an acute inflammatory episode may occur leading to the disappearance of the calcification. Although hydroxyapatite crystal-induced inflammation has been previously studied with synthetic crystals, no data are available with calcifications extracted from patients suffering from calcific tendinopathy. The objective of the study was to explore the inflammatory properties of human calcifications and the pathways involved. Methods Human calcifications and synthetic hydroxyapatite were used in vitro to stimulate human monocytes and macrophages, the human myeloid cell line THP-1, and human tenocytes. The release of IL-1β, IL-6, and IL-8 by cells was quantified by ELISA. The gene expression of pro- and anti-inflammatory cytokines was evaluated by quantitative PCR. NF-kB activation and NLRP3 involvement were assessed in THP-1 cells using a NF-kB inhibitor and a caspase-1 inhibitor. The inflammatory properties were then assessed in vivo using a mouse air pouch model. Results Human calcifications were able to induce a significant release of IL-1β when incubated with monocytes, macrophages, and THP-1 only if they were first primed with LPS (monocytes and macrophages) or PMA (THP-1). Stimulation of THP-1 by human calcifications led to similar levels of IL-1β when compared to synthetic hydroxyapatite although these levels were significantly inferior in monocytes and macrophages. The patient’s crystals enhanced mRNA expression of pro-IL-1β, as well as IL-18, NF-kB, and TGFβ when IL-6 and TNFα expression were not. IL-1β production was reduced by the inhibition of caspase-1 indicating the role of NLRP3 inflammasome. In vivo, injection of human calcifications or synthetic hydroxyapatite in the air pouch led to a significant increase in membrane thickness although significant overexpression of IL-1β was only observed for synthetic hydroxyapatite. Conclusions As synthetic hydroxyapatite, human calcifications were able to induce an inflammatory response resulting in the production of IL-1β after NF-kB activation and through NLRP3 inflammasome. In some experiments, IL-1β induction was lower with human calcifications compared to synthetic apatite. Differences in size, shape, and protein content may explain this observation.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a18bc9d94eb8b9d074ab6b6da7d601edTest
https://doi.org/10.21203/rs.3.rs-156807/v1Test -
7
المصدر: Joint bone spine. 88(2)
مصطلحات موضوعية: medicine.medical_specialty, business.industry, Ultrasound, medicine.disease, Rotator Cuff Injuries, Rotator Cuff, medicine.anatomical_structure, Rheumatology, Tendon Injuries, medicine, Humans, Rotator cuff, Radiology, business, Calcification, Ultrasonography
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::37a71e1231090a7c78b90d3784e62903Test
https://pubmed.ncbi.nlm.nih.gov/33186733Test -
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المؤلفون: Benoit Le Goff, Pascale Guillot, Joëlle Glémarec, Yves Maugars, Christelle Darrieutort-Laffite, Jean-Marie Berthelot
المصدر: Journal of Medical Case Reports, Vol 14, Iss 1, Pp 1-7 (2020)
Journal of Medical Case Reportsمصطلحات موضوعية: medicine.medical_specialty, Bone density, Fractures, Multiple, medicine.medical_treatment, Osteoporosis, lcsh:Medicine, Case Report, 030204 cardiovascular system & hematology, Tertiary hyperparathyroidism, Bone remodeling, 03 medical and health sciences, 0302 clinical medicine, Bone Density, medicine, Humans, Child, Bone mineral, Hyperparathyroidism, Hyperplasia, Bone Density Conservation Agents, business.industry, lcsh:R, Thyroidectomy, General Medicine, Middle Aged, medicine.disease, Surgery, Denosumab rebound, Fracture, Denosumab, 030220 oncology & carcinogenesis, Hypercalcemia, Female, business, Follow-Up Studies, medicine.drug
الوصف: Background The rebound effect after stopping treatment with denosumab may be associated with rapid loss of the gains in bone mineral density achieved with treatment, high levels of bone remodeling markers, the occurrence of vertebral fractures, and even hypercalcemia. Case presentation A 64-year-old osteoporotic Caucasian woman suffered from a fracture of her second lumbar vertebra in 2004. From January 2005, she was treated with denosumab for 9 years, with good densitometry results for her hip and lumbar areas, and no fractures over the last 6 years of treatment. Ten months after the treatment with denosumab was stopped, a cascade of vertebral fractures, including some in unusual locations (third thoracic vertebra), and multiple rib fractures in a context of hypercalcemia, suggested possible malignancy. A complete evaluation, including systemic, biological, and biopsy analyses, ruled out this hypothesis. The hypercalcemia was associated with normal plasma phosphate and vitamin D concentrations, and a high parathyroid hormone level, with an abnormal fixation of the lower lobe of the thyroid on sesta-methoxy-isobutyl-isonitrile scintigraphy. Histological analysis of the excised parathyroid tissue revealed hyperplasia. The associated thyroidectomy (goiter) led to the discovery of a thyroid papillary microcarcinoma. Conclusions We consider the consequences of this rebound effect, not only in terms of the major loss of bone density (return to basal values within 3 years) and the multiple disabling fracture episodes, but also in terms of the hypercalcemia observed in association with apparently autonomous tertiary hyperparathyroidism. Several cases of spontaneous reversion have been reported in children, but the intervention in our patient precluded any assessment of the possible natural course. The discovery of an associated thyroid neoplasm appears to be fortuitous. Better understanding of the various presentations of the rebound effect after stopping treatment with denosumab would improve diagnostic management of misleading forms, as in this case. Bisphosphonates could partially prevent this rebound effect.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2515c1e8c006be893b6d353178c6ef94Test
https://doi.org/10.1186/s13256-020-02401-0Test -
9
المؤلفون: Simon Rio, Guillaume Coiffier, Benoit Le Goff, Pascal Guggenbuhl, François Robin, Christelle Darrieutort-Laffite, Jean-David Albert
المساهمون: CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
المصدر: Joint Bone Spine
Joint Bone Spine, 2020, 87 (4), pp.364-365. ⟨10.1016/j.jbspin.2019.11.006⟩
Joint Bone Spine, Elsevier Masson, 2020, 87 (4), pp.364-365. ⟨10.1016/j.jbspin.2019.11.006⟩مصطلحات موضوعية: musculoskeletal diseases, medicine.medical_specialty, Steroid injection, Injections, Epidural, caudal hiatus epidural injection, 03 medical and health sciences, 0302 clinical medicine, Lumbar, Rheumatology, medicine, Humans, Lower lumbar radicular pain, 030212 general & internal medicine, Prospective Studies, ultrasound-guided, Radiculopathy, Ultrasonography, Interventional, 030203 arthritis & rheumatology, Lumbar Vertebrae, business.industry, Joint bone, medicine.disease, Ultrasound guided, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Radicular pain, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Observational study, Steroids, Radiology, business, Low Back Pain
الوصف: International audience; Lower lumbar radicular pain is a benign and frequent condition, mostly induced by disk herniation or osteoarthritis. The management of lower lumbar radicular pain is a public health problem, with multimodal management. Lumbar epidural steroid injections are considered as a treatment but their effectiveness remains controversial, with conflicting results. Injection via the caudal hiatus route (CH) under ultrasound (US) guidance has gained popularity because of accessibility or US equipment, absence of irradiation, feasibility and very few complications reported.A pragmatic prospective observational two-center (Rennes and Nantes University Hospitals) study was performed to evaluate the effectiveness of a single steroid (cortivazol) epidural injection delivered under US guidance via the CH on lower lumbar radicular pain. The primary outcome for success was achieving a numerical pain rating scale score (NPRS ≤ 3/10 at day 30 (D30) after epidural injection. The secondary endpoints were achieving a NPRS ≤ 3/10 at D30 without opiates and NSAIDs, level of analgesic and NSAIDs consumption, absence from work and occurrence of adverse events. Factors related to efficacy were not well established.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a5a5b79217b011b702095c1b7fbd0af0Test
https://univ-rennes.hal.science/hal-02442527/documentTest -
10
المؤلفون: Paul Arnolfo, Yves Maugars, Benoit Le Goff, Jean-Marie Berthelot, Christelle Darrieutort-Laffite, Joëlle Glémarec
المصدر: Joint bone spine. 88(1)
مصطلحات موضوعية: musculoskeletal diseases, medicine.medical_specialty, Lasègue test, Physical examination, Neurological examination, Sitting, 03 medical and health sciences, Sciatica, 0302 clinical medicine, Lumbar, Physical medicine and rehabilitation, Rheumatology, medicine, Humans, Medical history, 030212 general & internal medicine, Range of Motion, Articular, 030203 arthritis & rheumatology, Leg, Lumbar Vertebrae, medicine.diagnostic_test, business.industry, Lumbosacral Region, Test (assessment), medicine.symptom, business, Intervertebral Disc Displacement
الوصف: Diagnosis of sciatica mainly relies on pain reproduction by stretching of the lumbar roots since neurological examination and medical history are usually not sufficient to guarantee diagnosis. The Lasegue test is the most popular method, which starts with the straight leg-raising test (SLR). However it is not perfect, and is not always well performed or interpreted. Passive ankle dorsiflexion at the end of the SLR (Bragard test) is more sensitive, but can also remain normal in some cases of sciatica. Other stretching tests can help to recognise lumbar root damage in patients with poorly defined pain in a lower extremity: firstly, the Christodoulides test, i.e. reproduction of L5 sciatic pain by a femoral stretch test; secondly, the Slump test, performed on a patient in a sitting position, by slowly extending their painful leg then passively bending their neck (or the opposite); and thirdly, the Bowstring test, which requires, at the end of the Lasegue test, once the knee has been slightly flexed, pressing on the course of the peroneal and/or tibial nerves in the popliteal fossea to try and reproduce the exact pain felt by the patient. The combination of all these tests takes less than 2 minutes, and could improve both the sensitivity and specificity of the physical examination for the diagnosis of sciatica. This article is a review of the limitations of the Lasegue/SLR tests and of the efficacy of these other tests for stretching the lumbar roots.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::46a9eab49f1988767c89d527d2609134Test
https://pubmed.ncbi.nlm.nih.gov/32561431Test
