Focussing of extracorporal shock wave therapy (ESWT) in the treatment of calcifying tendinitis.

[6] or related to progressive destruction of the base of the distal phalanx by the rheumatoid process [1]. Acro-osteolysis has also been reported after trauma, burns, frostbite or neuropathic disorders such as insensitivity to pain and tarsal tunnel syndrome. It has also been observed in systemic diseases such as sarcoidosis, diabetes mellitus, renal diseases and hyperparathyroid-ism. Vascular disorders (Buerger's and Raynaud's disease), phenitoin or ergot treatment or intoxication with vinyl chloride have also been incriminated. Idiopathic forms [14] have occasionally been associated with joint erosions [15]. These latter differ from rheumatoid erosions by their rapid progression and their wide distribution. However, clinical manifestations can mimic juvenile chronic arthritis [16]. As no other cause could be disclosed, we hypothesised that our patient presented an idiopathic local form of osteolysis, not related to RA (preserved space of the distal interphalangeal joint), although the extension of the hand bony erosions probably denoted a longer RA evolution than admitted by the patient. Chronic vascu-lar insufficiency of the lower limbs could have contributed to the development of the acro-osteolysis. Clinical examination and biological results were not in favour of any vasculitis or neuropathy related to RA. Occurrence of both phenomena was probably fortuitous. familial acroosteolysis : histomorphometric study of bone and literature review of the Hajdu-Cheney syndrome. Acrodermatite continue de Hallopeau avec ostéolyse, précédant de 35 ans un psoriasis commun avec oligo-arthrite. Queiroz V. Idiopathic multicentric osteolysis : a rare disease mimicking juvenile chronic arthritis.