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

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

المؤلفون: Guillaume Coiffier, Pascal Guggenbuhl, Christelle Darrieutort-Laffite, Simon Rio, Benoit Le Goff, Jean-David Albert, François Robin

المساهمون: Nutrition, Métabolismes et Cancer (NuMeCan), 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), CHU Pontchaillou [Rennes], Centre hospitalier universitaire de Nantes (CHU Nantes), Jonchère, Laurent, 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)

المصدر: Revue du Rhumatisme
Revue du Rhumatisme, Elsevier, 2020, 87 (6), pp.492-493. ⟨10.1016/j.rhum.2020.09.001⟩
Revue du Rhumatisme, 2020, 87 (6), pp.492-493. ⟨10.1016/j.rhum.2020.09.001⟩

مصطلحات موضوعية: Échoguidée, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, business.industry, [SDV]Life Sciences [q-bio], Lomboradiculalgie, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Rheumatology, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Medicine, 030212 general & internal medicine, Infiltration épidurale par le hiatus sacrococcygien, business, 030217 neurology & neurosurgery, ComputingMilieux_MISCELLANEOUS

الوصف: National audience; [No abstract available]

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a7f6a8bd732ecc262adb8f87c81a70d6Test
https://hal.archives-ouvertes.fr/hal-03040865Test

المؤلفون: Blanchard, Christelle Darrieutort-Laffite, Paul Arnolfo, Thomas Garraud, Annie Adrait, Yohann Couté, Guy Louarn, Valérie Trichet, Pierre Layrolle, Benoit Le Goff, Frédéric

المصدر: Journal of Clinical Medicine; Volume 8; Issue 10; Pages: 1544

مصطلحات موضوعية: calcific tendonitis, rotator cuff, apatite, hypertrophic chondrocytes, tissue non-specific alkaline phosphatase

الوصف: Calcific tendonitis is a frequent cause of chronic shoulder pain. Its cause is currently poorly known. The objectives of this study were to better characterize the cells and mechanisms involved in depositing apatite crystals in human tendons. Histologic sections of cadaveric calcified tendons were analyzed, and human calcific deposits from patients undergoing lavage of their calcification were obtained to perform infrared spectroscopy and mass spectrometry-based proteomic characterizations. In vitro, the mineralization ability of human rotator cuff cells from osteoarthritis donors was assessed by alizarin red or Von Kossa staining. Calcifications were amorphous areas surrounded by a fibrocartilaginous metaplasia containing hypertrophic chondrocyte-like cells that expressed tissue non-specific alkaline phosphatase (TNAP) and ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), which are two key enzymes of the mineralization process. Calcific deposits were composed of apatite crystals associated with proteins involved in bone and cartilage development and endochondral bone growth. In vitro, tenocyte-like cells extracted from the rotator cuff were able to mineralize in osteogenic cultures, and expressed TNAP, type X COLLAGEN, and MMP13, which are hypertrophic chondrocytes markers. The use of a TNAP inhibitor significantly prevented mineral deposits. We provide evidence that tenocytes have a propensity to differentiate into hypertrophic chondrocyte-like cells to produce TNAP-dependent calcium deposits. We believe that these results may pave the way to identifying regulating factors that might represent valuable targets in calcific tendonitis.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=multidiscipl::8ad081ffbde02903fb253f0fb0e5485aTest

المؤلفون: Philippe Montigny, Grégoire Cormier, Benoit Le Goff, Céline Cozic, Gilles Tanguy, Christelle Volteau, Yves Maugars, Stéphane Varin, Joëlle Glémarec, Christelle Darrieutort Laffite

المصدر: Joint Bone Spine. 85:359-363

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Lidocaine, Visual analogue scale, medicine.drug_class, medicine.medical_treatment, Injections, Intralesional, Cortivazol, Placebo, Risk Assessment, Severity of Illness Index, Statistics, Nonparametric, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Rheumatology, Reference Values, 030202 anesthesiology, medicine, Humans, Prospective Studies, Anesthetics, Local, Glucocorticoids, Saline, Aged, Pain Measurement, Lumbar Vertebrae, Local anesthetic, business.industry, Lumbosacral Region, Middle Aged, Prognosis, Low back pain, Surgery, Treatment Outcome, Anesthesia, Drug Therapy, Combination, Female, medicine.symptom, Tomography, X-Ray Computed, business, Low Back Pain, 030217 neurology & neurosurgery, Lumbosacral joint, medicine.drug

الوصف: Objective The primary objective of this study was to compare the efficacy of local injection of a local anesthetic with a glucocorticoid versus a local anesthetic with saline to treat low back pain due to lumbosacral transitional vertebras (LSTV) with a pseudoarticulation. Methods A randomized placebo-controlled double-blind study was conducted in patients with unilateral low back pain ascribed clinically to LSTV. Patients were randomized to lidocaine plus saline (LS group) or lidocaine plus cortivazol (LC group) injected locally under computed tomography guidance. The primary outcome measure was the 24-hour mean visual analog scale (VAS) score for low back pain 4 weeks after the injection. Results Of 16 randomized patients, 15 were included in the analysis, 8 in the LS group and 7 in the LC group. The mean VAS pain score at week 4 was not significantly different between the two groups. In the two groups pooled, the mean VAS pain score decreased significantly from baseline to week 4, from 5.52 ± 0.99 to 3.86 ± 2.55 (P ≤ 0.05). The difference remained significant at week 12. Significant improvements occurred in the EIFEL disability index and items of the Dallas Pain Questionnaire. No adverse events were recorded. Conclusion In patients with chronic low back pain consistent with a symptomatic LSTV type II or IV in the Castellvi classification, a local injection of lidocaine with or without cortivazol may provide sustained improvements in pain and function. The underlying mechanism is unclear.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a9bfad3bd3d962e0479cdcb9f6bd8f59Test
https://doi.org/10.1016/j.jbspin.2017.05.003Test

المؤلفون: Joëlle Glémarec, Benoit Le Goff, Grégoire Cormier, Stéphane Varin, Céline Cozic, Philippe Montigny, Yves Maugars, Gilles Tanguy, Christelle Darrieutort Laffite, Christelle Volteau

المصدر: Revue du Rhumatisme. 85:276-279

مصطلحات موضوعية: 03 medical and health sciences, 0302 clinical medicine, Rheumatology, 030202 anesthesiology, 030217 neurology & neurosurgery

الوصف: Resume Objectif L’objectif principal de cette etude etait de comparer l’efficacite des infiltrations anesthesie locale et corticoides versus anesthesie locale et serum physiologique dans le traitement des anomalies transitionnelles de la charniere lombosacree (ATLS). Methodes Les patients presentant une lombalgie unilaterale cliniquement liee a une ATLS ont ete randomises pour infiltration en double insu lidocaine et serum physiologique (LSP) versus lidocaine et cortivazole (LC) sous scanner. Le critere principal etudie etait l’evolution de l’EVA moyenne des 24 dernieres heures a 4 semaines. Resultats Seuls 16 patients ont ete randomises et 15 etudies (8 LSP et 7 LC). Il n’existait pas de difference significative entre les 2 groupes sur l’EVA moyenne a S4. Par contre si on regardait l’evolution de l’ensemble des patients, on notait une amelioration significative de l’EVA a S4 par rapport au baseline : EVA 5,52 ± 0,99 a S0 et 3,86 ± 2,55 a S4 ( p = Conclusion Dans les douleurs chroniques evoquant une origine ATLS avec neoarticulation de type II ou IV de la classification de Castellvi une infiltration peut etre proposee car elle peut ameliorer la douleur et la fonction durablement sans prejuger du mecanisme de l’amelioration.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::4af2abcf871c6b8e6d7c3e4c1f1bdd46Test
https://doi.org/10.1016/j.rhum.2017.03.031Test

المؤلفون: Benoit Le Goff, Christelle Darrieutort-Laffite

المصدر: Revue du Rhumatisme Monographies. 85:102-107

مصطلحات موضوعية: 030203 arthritis & rheumatology, 030222 orthopedics, 03 medical and health sciences, 0302 clinical medicine, Rheumatology

الوصف: Resume Les tendinopathies calcifiantes sont une cause frequence de douleurs d’epaule volontiers chroniques et invalidantes. Differentes options therapeutiques s’offrent a nous pour prendre en charge ces patients. Dans cette revue, les moyens et options strategiques dans cette pathologie sont discutes et permettent de degager certaines notions. Le traitement par kinesitherapie et anti-inflammatoires non steroidiens peut etre tente en premiere intention puisque le caractere symptomatique de la calcification peut etre un marqueur de l’evolution vers la resorption. Cependant, la duree necessaire a la disparition spontanee des symptomes peut etre longue et difficilement previsible. Ensuite, environ un tiers des patients pourront repondre sur le long terme a une infiltration de la bourse sous-acromio-deltoidienne, les autres recidivant souvent lorsque l’effet de la corticotherapie locale s’attenue. C’est a ce stade qu’une intensification du traitement peu se discuter. Les donnees actuelles semblent favoriser la ponction-lavage-fragmentation (PFL) de la calcification aux ondes de chocs. Cette derniere permet de maniere plus rapide et frequente la disparition de la calcification et de la douleur. Cette affirmation est a temperer au vu de la qualite et quantite de donnees disponibles. Le guidage de la PFL se fait maintenant sous echographie et avec une technique a une aiguille qui est equivalente au lavage a 2 aiguilles. Enfin, la chirurgie est clairement indiquee en cas d’echec d’une prise en charge medicale complete, n’ayant jamais montre sa superiorite par rapport aux autres therapeutiques.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::43ef06a26461f367d4ef6f86fbd2a11fTest
https://doi.org/10.1016/j.monrhu.2018.01.002Test

المؤلفون: Jean-Marie Berthelot, Christelle Darrieutort-Laffite, Yves Maugars, Jean-Denis Laredo

المصدر: Joint Bone Spine. 85:41-45

مصطلحات موضوعية: medicine.medical_specialty, Nerve root, Dura mater, Diagnostic Techniques, Neurological, 03 medical and health sciences, 0302 clinical medicine, Lumbar, Rheumatology, Ganglia, Spinal, medicine, Humans, Radiculopathy, 030203 arthritis & rheumatology, Sciatica, business.industry, Nerve Compression Syndromes, Lumbosacral Region, Anatomy, medicine.disease, Surgery, Periradicular, medicine.anatomical_structure, Thecal sac, medicine.symptom, Arachnoiditis, Spinal Nerve Roots, Radiculopathies, business, 030217 neurology & neurosurgery

الوصف: Purpose To perform a synthesis of articles addressing the role of stretching on roots in the pathophysiology of radiculopathy. Methods Review of relevant articles on this topic available in the PubMed database. Results An intraoperative microscopy study of patients with sciatica showed that in all patients the hernia was adherent to the dura mater of nerve roots. During the SLR (Lasegue's) test, the limitation of nerve root movement occurs by periradicular adhesive tissue, and temporary ischemic changes in the nerve root induced by the root stretching cause transient conduction disturbances. Spinal roots are more frail than peripheral nerves, and other mechanical stresses than root compression can also induce radiculopathy, especially if they also impair intraradicular blood flow, or the function of the arachnoid villi intimately related to radicular veins. For instance arachnoiditis, the lack of peridural fat around the thecal sac, and epidural fibrosis following surgery, can all promote sciatica, especially in patients whose sciatic trunks also stick to piriformis or internus obturator muscles. Indeed, stretching of roots is greatly increased by adherence at two levels. Conclusions As excessive traction of nerve roots is not shown by imaging, many physicians have unlearned to think in terms of microscopic and physiologic changes, although nerve root compression in the lumbar MRI is lacking in more than 10% of patients with sciatica. It should be reminded that, while compression of a spinal nerve root implies stretching of this root, the reverse is not true: stretching of some roots can occur without any visible compression.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5af4ecfabfd34a61a907e0e8f756e64bTest
https://doi.org/10.1016/j.jbspin.2017.01.004Test

المؤلفون: Jean-Denis Laredo, Jean-Marie Berthelot, Christelle Darrieutort-Laffite, Yves Maugars

المصدر: Revue du Rhumatisme. 84:486-491

مصطلحات موضوعية: 030222 orthopedics, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, 030217 neurology & neurosurgery

الوصف: Resume Objectif Realiser une synthese d’articles abordant le role de l’etirement radiculaire dans la physiopathologie de la radiculopathie. Methodes Revue d’articles pertinents sur ce theme disponibles dans la base de donnees PubMed. Resultats Une etude microscopique peroperatoire de patients presentant une sciatique a revele dans tous les cas une adherence de la hernie a la dure-mere des racines nerveuses. Lors du test d’elevation de la jambe tendue ( Straight leg raising [SLR], manœuvre de Lasegue), l’adherence des tissus periradiculaires limite le deplacement de la racine nerveuse, et des modifications ischemiques transitoires dans la racine provoquees par l’etirement perturbent temporairement la conduction. Les racines rachidiennes sont plus fragiles que les nerfs peripheriques, et d’autres contraintes mecaniques que la compression radiculaire peuvent provoquer une radiculopathie, en particulier si elles alterent egalement le flux sanguin intraradiculaire ou la fonction des villosites arachnoidiennes, etroitement liees aux veines radiculaires. Ainsi, l’arachnoidite (disparition de la graisse peridurale autour du sac dural) et la fibrose epidurale postoperatoire peuvent favoriser une sciatique, notamment chez des patients dont le tronc sciatique adhere egalement au muscle piriforme ou obturateur interne. De fait, l’etirement radiculaire est fortement accru par une adherence a deux niveaux. Conclusions L’exces de traction des racines nerveuses n’etant pas visible a l’imagerie, nombre de medecins ont perdu l’habitude de prendre en consideration les changements microscopiques et physiologiques, alors que dans plus de 10 % des sciatiques, la compression des racines nerveuses n’apparait pas sur l’IRM lombaire. Rappelons que si la compression de la racine d’un nerf spinal implique un etirement radiculaire, l’inverse n’est pas vrai : il arrive que des racines soient etirees sans qu’aucune compression ne soit visible.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::378caaa758bdf838eeb4b4affd44e688Test
https://doi.org/10.1016/j.rhum.2017.04.006Test

المؤلفون: Yves Maugars, Charles Sougué, Benoit Le Goff, Christelle Darrieutort-Laffite

المصدر: Revue du Rhumatisme. 88:76-77

مصطلحات موضوعية: Rheumatology

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::c1162d1c4f537b9ea15d89c1dd01a4a9Test
https://doi.org/10.1016/j.rhum.2020.09.019Test