The non-traumatic shoulder physical examinations starts with a specific history followed by an observation of both shoulders at rest and during anterior elevation and abduction movements that must remain symetrical. Thereafter, the patient must be asked to indicate precisely where the pain is located. Active and passive mobilities are evaluated. In case of a major reduction of both passive and active mobility of the shoulder, which is accompanied by severe pain, the occurrence of an adhesive capsulitis should be suspected. The tendons of the rotator cuff must be evaluated with the traditional specific tests. The impigment tests must also take place, as tendon injuries often go along with subacromial impigment. Finally, palpation of the tendon of the rotator cuff as well as motor testing of the muscles of the shoulder including the serratus anterior will end the physical examination of a non-traumatic painful shoulder.
CDK4/6 inhibitors are a new standard of care in the management of metastatic breast cancer patients. In the early setting, the use of genomic tests will better define the patients who will benefit the most from adjuvant chemotherapy.
Breast cancer occurs in 12% of the female population. If in most of the case this affection is sporadic, heredity plays a role in 10-15% of the cases. In certain personal of familial situations, a genetic analysis can be proposed to the patients after genetic counselling. When a germline mutation is found in a family, a predictive genetic testing can be proposed to “at risk” relatives to take preventive measures. General practitioners, caretaker of the familial history, plays an important role in the follow-up and support, as in the information’s transmission in the family.
Alexandre Jacquerie ¹, Elodie Georges¹, Charlotte Van Ende², Gabriela Migali², Benoit Ghaye³, Michel Lambert¹Published in the journal : April 2017Category : Internal Medicine
We report the case of a 43-year-old woman presenting with atypical back pain caused by a tumor-like paraspinal mass. This turned out be a rare presentation of granulomatosis with polyangiitis (GPA) or Wegener's disease.
Key Words
Back pain, tumor-like mass, thoracic spine lesion, GPA
Laurine Sacré (1), Isabelle Tromme (1), Jean-François Baurain (2), Benoit Lengelé (3), Marie Baeck (1)Published in the journal : April 2017Category : Dermatology
We report here on the "PEAU’se dermatologique" meeting, held on January 16, 2016, focusing on melanoma diagnosis and new treatments. Doctor I. Tromme presented her thesis results concerning melanoma detection by means of optical and digital dermoscopy. Professor JF. Baurain provided us with a better understanding of new systemic therapies for metastatic melanomas. Lastly, Professor B. Lengelé shared with us his experience in electrochemotherapy for managing primary or metastatic cutaneous tumors.
Key Words
Melanoma, optical and digital dermoscopy, targeted therapy, elcetrochemotherapy
Georges de Bilderling (1), Claire Geurten (1), Jean Evrard (1), François Kanen (1), Laurent Houtekie (2), Alain Poncelet (3), Karlien Carbonez (4), Stéphane Moniotte (4)Published in the journal : April 2017Category : Pediatrics
A 2-month-old baby is admitted to our unit for bronchiolitis. Due to the infant's prolonged symptoms with predominant feeding difficulties and because of a heart murmur noted on auscultation, cardiac ultrasound is performed, resulting in the diagnosis of ALCAPA syndrome (Anomalous Left Coronary Artery from Pulmonary Artery). ALCAPA is a rare but severe cardiac malformation, with early diagnosis and treatment being key to a good prognosis. Bronchiolitis can provoke heart failure, whereas clinical features of heart failure may mimic bronchiolitis. This clinical case underlines the need for performing a complete clinical examination, along with oriented diagnostic investigations, when confronted with a baby suffering from a respiratory condition whose severity or evolution appears unusual.
Edeline Kaze (1), François D’heygere (2)Published in the journal : April 2017Category : Rare Diseases
The combined syndrome of juvenile polyposis / inherited hemorrhagic telangiectasia (JD-HHT Syndrome) is rare, caused by mutations in the MADH4 gene. Affected individuals exhibit the clinical manifestations of both pathologies and are at increased risk of gastrointestinal cancer (1).
Alexandre Hupez (a-b), M.D., Christine Detrembleur (c), Ph.D, Fernand Van Innis (a), M.D., Serge Troussel (a), M.D., Xavier Libouton (b-c), M.D, Ph.D., Thierry Lequint (a), M.D.Published in the journal : April 2017Category : Orthopedics
This study sought to evaluate the use of collagenase injections for Dupuytren's contracture (19 compared to fasciectomy, with 19 patients assessed in each group. We measured loss of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint extension at baseline and 12 months post-injection, along with its impact on patients' daily life, pain, and satisfaction. Whereas there was no significant between-group difference observed for loss of MCP joint extension, PIP joint extension proved lower for the surgical group compared to the injection group. The injection group exhibited significant improvements in terms of pain, daily activities, and satisfaction regarding the MCP joints, with no between-group differences observed for the PIP joints.
This article presents the association bisoprolol/perindopril (Bipressil®), along with its indications and advantages, in the cardiovascular disease setting.