{"id":359,"date":"2026-03-18T20:34:43","date_gmt":"2026-03-18T19:34:43","guid":{"rendered":"https:\/\/erlaxatu.fr\/index.php\/cas-clinique-monoarthrite-poignet\/"},"modified":"2026-03-18T20:34:43","modified_gmt":"2026-03-18T19:34:43","slug":"cas-clinique-monoarthrite-poignet","status":"publish","type":"page","link":"https:\/\/erlaxatu.fr\/index.php\/cas-clinique-monoarthrite-poignet\/","title":{"rendered":"Monoarthrite poignet"},"content":{"rendered":"\n<style>\n.cc-wrap {\n  max-width: 900px;\n  margin: 0 auto;\n  padding: 28px 16px 40px;\n  font-family: -apple-system, BlinkMacSystemFont, \"Segoe UI\", Roboto, Helvetica, Arial, sans-serif;\n  color: #1f2a37;\n}\n.case-box, .qcm, .comment-box {\n  background: #ffffff;\n  border: 2px solid #d7dee8;\n  border-radius: 12px;\n  padding: 18px;\n  margin: 14px 0;\n}\n.case-box h2 {\n  margin: 0 0 8px;\n  font-size: 1.1rem;\n  color: #2563eb;\n}\n.case-box p {\n  margin: 0;\n  white-space: pre-line;\n}\n.case-images {\n  display: grid;\n  gap: 10px;\n  margin-top: 12px;\n  justify-items: center;\n}\n.case-images img {\n  width: 70% !important;\n  max-width: 520px !important;\n  height: auto;\n  margin: 0 auto;\n  display: block;\n  border: 1px solid #d7dee8;\n  border-radius: 10px;\n  cursor: zoom-in;\n}\n.img-modal {\n  position: fixed;\n  inset: 0;\n  display: none;\n  z-index: 99999;\n}\n.img-modal.is-open {\n  display: block;\n}\n.img-modal-backdrop {\n  position: absolute;\n  inset: 0;\n  background: rgba(2, 6, 23, 0.84);\n}\n.img-modal-inner {\n  position: relative;\n  z-index: 1;\n  width: min(96vw, 1200px);\n  height: min(94vh, 900px);\n  margin: 3vh auto;\n  display: grid;\n  grid-template-rows: auto 1fr;\n  gap: 10px;\n}\n.img-modal-toolbar {\n  display: flex;\n  justify-content: flex-end;\n  gap: 8px;\n}\n.img-btn {\n  border: 1px solid #1d4ed8;\n  background: #2563eb;\n  color: #fff;\n  border-radius: 8px;\n  padding: 6px 10px;\n  font-size: 0.92rem;\n  font-weight: 600;\n  cursor: pointer;\n}\n.img-modal-stage {\n  background: rgba(15, 23, 42, 0.9);\n  border: 1px solid rgba(148, 163, 184, 0.4);\n  border-radius: 12px;\n  overflow: hidden;\n  display: grid;\n  place-items: center;\n  cursor: grab;\n  touch-action: none;\n}\n.img-modal-stage.is-dragging {\n  cursor: grabbing;\n}\n.img-modal-image {\n  max-width: 100%;\n  max-height: 100%;\n  width: auto;\n  height: auto;\n  transform-origin: center center;\n  transition: transform 120ms ease;\n  cursor: zoom-in;\n  user-select: none;\n  touch-action: none;\n}\n.q-title {\n  font-weight: 700;\n  margin: 0 0 10px;\n}\n.options {\n  display: grid;\n  gap: 8px;\n  margin-top: 8px;\n}\n.option {\n  display: flex;\n  align-items: flex-start;\n  gap: 10px;\n  border: 1px solid #d7dee8;\n  background: #fff;\n  border-radius: 10px;\n  padding: 10px 12px;\n  cursor: pointer;\n  font-size: 0.98rem;\n}\n.option:hover {\n  border-color: #2563eb;\n}\n.option input[type=\"checkbox\"] {\n  margin-top: 2px;\n  transform: scale(1.1);\n  accent-color: #2563eb;\n}\n.qcm.corrected .option[data-correct=\"true\"] {\n  border-color: #047857;\n  background: #d1fae5;\n}\n.qcm.corrected .option[data-correct=\"true\"] span {\n  color: #047857;\n  font-weight: 600;\n}\n.qcm.corrected .option[data-correct=\"false\"] input:checked {\n  accent-color: #b91c1c;\n}\n.qcm.corrected .option[data-correct=\"false\"] input:checked + span {\n  color: #b91c1c;\n  font-weight: 600;\n}\n.qcm-actions {\n  display: flex;\n  gap: 10px;\n  margin-top: 12px;\n}\n.flip-btn {\n  border: 1px solid #2563eb;\n  background: #2563eb;\n  color: #fff;\n  border-radius: 10px;\n  padding: 8px 12px;\n  cursor: pointer;\n  font-size: 0.92rem;\n  font-weight: 600;\n  display: inline-block;\n}\n.comment-box summary {\n  cursor: pointer;\n  font-weight: 700;\n  color: #2563eb;\n}\n.comment-box p {\n  margin-top: 10px;\n}\n<\/style>\n\n<div class=\"cc-wrap\">\n  <section class=\"case-box\">\n    <h2>Situation clinique<\/h2>\n    <p>Une patiente de 77 ans pr\u00e9sente depuis 48 heures une tum\u00e9faction douloureuse de la main gauche, d\u2019apparition rapide, avec impotence fonctionnelle partielle. La main est chaude, oed\u00e9mati\u00e9e, sans notion de traumatisme r\u00e9cent. Vous \u00e9voquez une arthrite aigu\u00eb microcristalline.<\/p>\n    <div class=\"case-images\"><img class=\"cc-zoomable\" src=\"https:\/\/erlaxatu.fr\/wp-content\/uploads\/2026\/03\/cca.png\" alt=\"Illustration du cas clinique\" loading=\"lazy\" decoding=\"async\"><\/div>\n  <\/section>\n\n  <form class=\"qcm\" data-question=\"1\">\n      <p class=\"q-title\">Question 1<\/p>\n      <div class=\"options\">\n        <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>Le d\u00e9but brutal est en faveur d\u2019une arthrite microcristalline<\/span><\/label>\n          <label class=\"option\" data-correct=\"false\"><input type=\"checkbox\"> <span>Une polyarthrite rhumato\u00efde d\u00e9butante est le diagnostic le plus probable<\/span><\/label>\n          <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>Une articulation chaude et oed\u00e9mati\u00e9e peut correspondre \u00e0 une arthrite septique<\/span><\/label>\n          <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>Le contexte d\u2019\u00e2ge avanc\u00e9 est compatible avec une chondrocalcinose<\/span><\/label>\n          <label class=\"option\" data-correct=\"false\"><input type=\"checkbox\"> <span>Un oed\u00e8me diffus du dos de la main exclut une atteinte articulaire<\/span><\/label>\n      <\/div>\n      <div class=\"qcm-actions\">\n        <button type=\"button\" class=\"flip-btn qcm-toggle-btn\">Correction<\/button>\n      <\/div>\n    <\/form><form class=\"qcm\" data-question=\"2\">\n      <p class=\"q-title\">Question 2<\/p>\n      <div class=\"options\">\n        <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>La radiographie peut montrer une chondrocalcinose<\/span><\/label>\n          <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>La CRP peut \u00eatre augment\u00e9e<\/span><\/label>\n          <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>La ponction articulaire peut rechercher des cristaux<\/span><\/label>\n          <label class=\"option\" data-correct=\"false\"><input type=\"checkbox\"> <span>L\u2019uric\u00e9mie normale \u00e9limine une pathologie microcristalline<\/span><\/label>\n          <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>Une \u00e9chographie articulaire peut aider \u00e0 l\u2019\u00e9valuation<\/span><\/label>\n      <\/div>\n      <div class=\"qcm-actions\">\n        <button type=\"button\" class=\"flip-btn qcm-toggle-btn\">Correction<\/button>\n      <\/div>\n    <\/form><form class=\"qcm\" data-question=\"3\">\n      <p class=\"q-title\">Question 3<\/p>\n      <div class=\"options\">\n        <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>Une arthrite septique doit \u00eatre \u00e9limin\u00e9e<\/span><\/label>\n          <label class=\"option\" data-correct=\"false\"><input type=\"checkbox\"> <span>La pr\u00e9sence de fi\u00e8vre \u00e9limine une arthrite microcristalline<\/span><\/label>\n          <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>La colchicine peut \u00eatre utilis\u00e9e selon le terrain<\/span><\/label>\n          <label class=\"option\" data-correct=\"false\"><input type=\"checkbox\"> <span>Le repos strict prolong\u00e9 pendant plusieurs semaines est obligatoire<\/span><\/label>\n          <label class=\"option\" data-correct=\"true\"><input type=\"checkbox\"> <span>Une infiltration ou corticoth\u00e9rapie peut se discuter apr\u00e8s \u00e9limination d\u2019une infection<\/span><\/label>\n      <\/div>\n      <div class=\"qcm-actions\">\n        <button type=\"button\" class=\"flip-btn qcm-toggle-btn\">Correction<\/button>\n      <\/div>\n    <\/form>\n\n  <details class=\"comment-box\">\n    <summary>Commentaire final (cliquer pour afficher)<\/summary>\n    <p>Il s\u2019agit d\u2019une mono- ou oligoarthrite aigu\u00eb de la main chez une patiente \u00e2g\u00e9e, \u00e9vocatrice en premier lieu d\u2019une arthropathie microcristalline, notamment \u00e0 cristaux de pyrophosphate de calcium. Le diagnostic diff\u00e9rentiel principal est l\u2019arthrite septique, qui doit toujours \u00eatre \u00e9limin\u00e9e en cas d\u2019articulation chaude et inflammatoire. La radiographie peut montrer des calcifications cartilagineuses en faveur d\u2019une chondrocalcinose. La ponction articulaire, quand elle est r\u00e9alisable, permet de rechercher des cristaux et d\u2019\u00e9liminer une infection. Le traitement repose sur le repos, la glace, les AINS ou la colchicine selon le terrain, voire une corticoth\u00e9rapie apr\u00e8s \u00e9limination d\u2019une infection.<\/p>\n  <\/details>\n\n  <script>\n(function () {\n  \/\/ QCM toggles (independent from any specific wrapper)\n  document.querySelectorAll(\".qcm\").forEach(function (form) {\n    var toggleBtn = form.querySelector(\".qcm-toggle-btn\");\n    if (!toggleBtn) return;\n\n    toggleBtn.addEventListener(\"click\", function () {\n      var isCorrected = form.classList.contains(\"corrected\");\n\n      if (!isCorrected) {\n        form.classList.add(\"corrected\");\n        toggleBtn.textContent = \"Question\";\n        return;\n      }\n\n      form.classList.remove(\"corrected\");\n      form.querySelectorAll('input[type=\"checkbox\"]').forEach(function (cb) {\n        cb.checked = false;\n      });\n      toggleBtn.textContent = \"Correction\";\n    });\n  });\n\n  var zoomableImages = document.querySelectorAll(\".cc-zoomable\");\n  if (zoomableImages.length === 0) {\n    return;\n  }\n\n  \/\/ Create a global image modal once\n  if (!document.querySelector(\".img-modal\")) {\n    var modal = document.createElement(\"div\");\n    modal.className = \"img-modal\";\n    modal.setAttribute(\"aria-hidden\", \"true\");\n    modal.innerHTML =\n      '<div class=\"img-modal-backdrop\"><\/div>' +\n      '<div class=\"img-modal-inner\" role=\"dialog\" aria-modal=\"true\" aria-label=\"Image agrandie\">' +\n        '<div class=\"img-modal-toolbar\">' +\n          '<button type=\"button\" class=\"img-btn img-zoom-out\" aria-label=\"Zoom moins\">-<\/button>' +\n          '<button type=\"button\" class=\"img-btn img-zoom-in\" aria-label=\"Zoom plus\">+<\/button>' +\n          '<button type=\"button\" class=\"img-btn img-close\" aria-label=\"Fermer\">Fermer<\/button>' +\n        '<\/div>' +\n        '<div class=\"img-modal-stage\">' +\n          '<img class=\"img-modal-image\" src=\"\" alt=\"Image agrandie\" decoding=\"async\">' +\n        '<\/div>' +\n      '<\/div>';\n    document.body.appendChild(modal);\n  }\n\n  var modal = document.querySelector(\".img-modal\");\n  var modalImage = modal.querySelector(\".img-modal-image\");\n  var modalStage = modal.querySelector(\".img-modal-stage\");\n  var zoomInBtn = modal.querySelector(\".img-zoom-in\");\n  var zoomOutBtn = modal.querySelector(\".img-zoom-out\");\n  var closeBtn = modal.querySelector(\".img-close\");\n\n  var scale = 1;\n  var tx = 0;\n  var ty = 0;\n  var dragging = false;\n  var dragPointerId = null;\n  var dragStartX = 0;\n  var dragStartY = 0;\n  var dragStartTx = 0;\n  var dragStartTy = 0;\n\n  function applyTransform() {\n    modalImage.style.transform = \"translate(\" + tx + \"px, \" + ty + \"px) scale(\" + scale + \")\";\n    if (scale > 1) {\n      modalImage.style.cursor = dragging ? 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