Profile of cervicobrachial neuralgia among rheumatology patients in Lomé, Togo

Abstract

Objectives: To determine the frequency and the different clinical forms of cervicobrachial neuralgia in a rheumatological setting in Lomé, Togo.
Design: This was a cross-sectional multicenter study conducted from January 2012 to December 2018 on the records of patients seen in the three rheumatology units in Lomé, Togo.
Methods: Patients who reported for consultation purposely because of cervicobrachial neuralgia were included. Diagnosis of the various clinical forms of degenerative cervical spine disease was essentially clinical, whereas radiological imaging findings contributed to the diagnosis of spondylodiscitis and neoplastic disease.
Results: Cervicobrachial neuralgia was the reason for the clinic visit in 143 (0.69%) out of the 14,346 patients examined over the eight year study period. These 143 patients comprising 84 women (58.74%) and 59 men (41.26%) had a mean age of 53.36±13.33 years. The average time to consultation was two years. Degenerative disease (138 cases,
96.5%) was the most commonly observed pathology. It included the following clinical forms: cervical osteoarthritis (n=120; 83.91%), cervical myelopathy (n=13; 9.10%) and herniated disc (n=5; 3.49%). Disc degeneration in isolation (60.83%) was the main radiographic finding in patients with degenerative disease. Spondylodiscitis was probably due to tuberculosis in the four patients who had it and two of them were HIV- positive. Bone metastasis from prostate cancer was found in one case.
Conclusion: Cervicobrachial neuralgia appears to be significant among rheumatology patients in Lomé. It predominantly affects adult women in professional activity. Although
mainly dominated by degenerative pathology, its aetiologies can also be infectious as well as neoplastic, hence the relevance of modern imaging modalities.

Key words: Cervicobrachial neuralgia, Osteoarthritis, Spondylodiscitis, Tumours, Sub-Saharan Africa