Low back pain in hospital outpatients in Lomé (Togo)

OBJECTIVE: To determine the patterns of low back pain and the conditions associated with this symptom in outpatients attending the rheumatology unit of the Lomé Teaching Hospital. METHODS: Medical records of patients seen over a ten-year period were studied retrospectively. RESULTS: Among the 9,065 patients seen during the study period, 3,204 (35.34%; 1,850 women and 1,354 men) had low back pain. Mean age at onset was 41 years, and mean duration of low back pain was three years. Diseases associated with low back pain were as follows: degenerative spinal disease, N = 3,054 (95.32%); spinal infections, N = 79 (2.47%); spondyloarthropathies, N = 44 (1.37%); and tumors, N = 27 (0.84%). The patterns of degenerative spinal disease included low back pain (N = 1,535, 47.91%), low back pain with nerve root pain suggestive of disk herniation (N = 1,108, 34.58%), and low back pain with nerve root pain and claudication suggestive of lumbar spinal stenosis (N = 411, 12.83%). Sch?ber's index was abnormal in 831 of the 1,408 patients (59%) with acute pain or disk herniation. Most patients with lumbar spinal stenosis were women (72.26%) and were aged 35 to 64 years. Findings suggestive of tuberculosis were present in 62 of the 79 patients with lumbar spinal infection. Among the 44 patients with spondyloarthropathies, 15 had ankylosing spondylitis and 11 had infection with the human immunodeficiency virus (HIV). Multiple myeloma was present in ten patients and metastatic tumors in eight. CONCLUSION: Low back pain seems to be as common in sub-Saharan Africa as in occidental countries, with a prevalence of one-third among rheumatology outpatients. Lumbar spinal stenosis seems more common than in the occident and is mainly observed in woman. Sch?ber's index is not useful for measuring forward bending of the lumbar spine in Africans. The epidemiology of spondyloarthropathies in sub-Saharan Africa has been changed by the expanding HIV epidemic, despite the low prevalence of the HLA B27 phenotype.     

La lombalgie en consultation hospitalière à Lomé (Togo)Low back pain in hospital outpatients in Lomé (Togo).

Objective. To determine the patterns of low back pain and the conditions associated with this symptom in outpatients attending the rheumatology unit of the Lomé teaching hospital. Methods. Medical records of patients seen over a ten-year period were studied retrospectively. Results. Among the 9065 patients seen, 3204 (35.34%; 1850 women and 1354 men) had low back pain. Mean age at onset was 41 years, and mean duration of low back pain was 3 years. Diseases associated with low back pain were as follows: degenerative spinal disease, N= 3054 (95.32 %); spinal infections, N=79 (2.47 %) ; spondyloarthropathies, N=44 (1.37 %) ; and tumors, N=27 (0.84 %). The features of degenerative spinal disease included back pain (n=1535, 47.91 %), lumbar and radicular pain suggestive of disc herniation (n=1108, 34.58 %), and lumbar and radicular pain with claudication suggestive of lumbar spinal stenosis (n=411, 12.83 %). Schöber’s test was abnormal in 831 of the 1408 patients (59 %) with acute pain or disc herniation. Most patients with lumbar spinal stenosis were women (72.26 %) and were aged 35 to 64 years. Findings suggestive of tuberculosis were present in 62 of the 79 patients with lumbar spinal infection. Among the 44 patients with spondyloarthropathies, 15 had ankylosing spondylitis and 11 had infection with the human immunodeficiency virus (HIV). Multiple myeloma was present in 10 patients and metastatic tumors in eight. Conclusion. Low back pain seems to be as common in sub-Saharan Africa as in occidental countries, with a prevalence of one-third among rheumatology outpatients. Lumbar spinal stenosis seems more common than in the Occident and is mainly observed in woman.  Schöber’s test is not useful for measuring lumbar flexion in Africans. The epidemiology of spondyloarthropathies in sub-Saharan Africa has been changed by the expanding HIV epidemic, despite the low prevalence of HLA B27.     

Rare mass of the anterior mediastinum: Thymolipomas

Thymolipoma is a rare benign neoplasm of the thymus containing both mature adipose tissue and thymic tissue. We report a case of a 34‐year‐οld man, presenting a mass of the anterior mediastinum, the radiology investigation and operatory piece diagnosed a thymolipoma.This study highlights the clinical diagnostic and therapeutic features as well as the evolutionary characteristics of this entity.     

Unusual cause of binocular diplopia: Cavernous sinus hemangioma

Cavernous hemangiomas are rare account representing 5%-13% of the intracranial vascular malformations and occur in approximately 0.5%-1% of the population. We report the case of 34-years-old woman, having a medical history of seizure, admitted for headache with binocular diplopia. The radiology investigation and operatory piece has shown an association of cavernous sinus hemangioma and frontal focal cortical dysplasia. This study highlights clinical, radiological and therapeutic features of this entity.