[Lower costovertebral arthritis in rheumatic pelvispondylitis. Pseudourologic manifestation].
Costo-vertebral and costo-transverse joints are often involved during rheumatoid pelvispondylitis. Their involvement may lead to thoracic ankylosis and decreased respiratory capabilities. These arthritis may also cause intercostal or pseudo-visceral pains. The authors report three cases of lower costo-vertebral arthritis, revealed by pseudo-urological, acute or subacute pains. The diagnosis was made on clinical findings (especially mobilization of the lower ribs) and confirmed by X-Rays (especially tomodensitometry). One of the cases presents an image of unilateral pedicle opacity secondary to costovertebral arthritis. The pseudo-urological manifestation of the pain is likely explained by the anatomical relationship between costo-vertebral joints and the sympathetic communicating rami. This close anatomical relationship was confirmed by dissection. Through the communicating rami, the costo-vertebral joints are thus in relation with the sympathetic system, which is responsible for the sensory innervation of the renal space. The pseudo-urological revelation of this arthritis should be compared to that of costal sprains.
D000328:Adult; D001168:Arthritis / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007596:Joints / Q000033:anatomy & histology; D007674:Kidney Diseases / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012272:Ribs / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000175:diagnosis; D013564:Sympathetic Nervous System / Q000033:anatomy & histology; D013904:Thoracic Vertebrae / Q000033:anatomy & histology / Q000000981:diagnostic imaging
Arthrites costo-vertébrales inférieures de la pelvispondylite rhumatismale. Révélation pseudo-urologique.