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Purpose: To propose polyhydramnios seen during prenatal diagnosis as a warning sign of foetal malformation., Patients and Methods: A retrospective multicentre study over a three-year period carried out in Ivory Coast and Burkina Faso. We reviewed 3903 obstetric ultrasound reports. All cases of foetal malformation and polyhydramnios were counted. The instances of foetal malformation associated with polyhydramnios were compared to those of foetal malformation without polyhydramnios and to polyhydramnios only., Results: A list of 72 cases of polyhydramnios was made (equating to 1.8%). In 55 cases (76.4%), polyhydramnios was combined with foetal malformation. These were lethal abnormalities in 33 cases and non-lethal in 22 cases. In 17 cases, polyhydramnios was not associated with any foetal malformations and in eight cases, foetal malformation was discovered in the absence of polyhydramnios. Polyhydramnios had a positive predictive value of 76.4% for the presence of foetal malformation. The negative predictive value was 99.8%. Sensitivity was 87.3% and specificity was 99.5%., Conclusion: Polyhydramnios is a highly sensitive and specific sign for prenatal diagnosis of foetal malformation. If it is identified, then this should lead to a very careful search for foetal malformation., (Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

We performed hysterosalpingography (HSG) and transvaginal ultrasound (TVU) in 124 Ivorian women as part of an infertility evaluation. The aim was to investigate the causes of infertility and show the advantages of combining HSG and TVU as part of a comprehensive evaluation of infertility in African woman. TVU and HSG were normal in 35.5% of cases, while in 64.5% of cases, at least one disease was demonstrated. This included uterine pathology in 50.3%, tubal disease in 25.2%, ovarian pathology in 7.5% and peritoneal pathology in 7% of cases. Of all the diseases identified by the association HSG and TVU, 71.3% were found by TVU, while 61.5% were confirmed by HSG. TVU was more efficient in identifying uterine and ovarian pathologies while HSG excelled in tubal pathology. HSG and TUV had identical performances on the peritoneal pathology. The association HSG-ETV should be systematic in the full assessment of female infertility in sub-Saharan Africa.

Purpose: To evaluate the diagnostic value of indirect ultrasound signs during acute appendicitis., Patients and Methods: Our retrospective study lasted 5 years, from May 2005 to April 2010. It concerned 620 cases of appendectomy performed following prior ultrasound examination of the right iliac fossa (RIF). In 448 cases, ultrasonography clearly showed the appendix, which was inflamed. The presence of indirect signs of appendix inflammation without visualisation of the appendix was confirmed by ultrasound examination in 160 cases. In 12 cases, the appendix was not visualised nor were there any indirect signs on the ultrasound image. The indirect signs involved were hypertrophy of the peritoneal fat (HPF), pain caused by compression on exploration of the right iliac fossa, and localised hypokinesia in the digestive loops (LHL). We compared the results found by ultrasonography with the operative and anatomical pathology reports., Results: The positive predictive value of the indirect signs of appendicitis on the ultrasound scan was 95.8% if the three indirect signs were associated, 87.5% for the association of pain and HPF, 45.8% for the association of pain and LHL, and 25% if there was just pain. The negative predictive value of the indirect signs of appendicitis on the ultrasound scan was 57.2% if the three signs were associated, 65.9% for the association of pain and HPF and 60.7% for the association of pain and LHL, with 83.3% for pain alone. The sensitivity of the indirect signs was 83.9% if the three signs were associated, 31.8% for the association of pain and HPF, 50% for the association of pain and LHL, and 50% if there was just pain. The specificity of the indirect signs was 85.7% if the three signs were associated, 96.7% for the association of pain and HPF, 56.7% for the association of pain and LHL, and 62.5% if there was just pain., Conclusion: When tomodensitometry cannot be performed and the appendix is not visible on ultrasound examination, indirect ultrasound signs must be systematically sought, particularly in populations in which appendicitis are highly prevalent., (Copyright © 2011 Éditions Françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Objective: The aim of our study was to describe current ultrasound and epidemiological features of ectopic pregnancy in Abidjan, Côte d'Ivoire., Patients and Methods: This prospective study was carried out over a 24-month period (February 2006 to January 2008) at Nanglé Medical Clinic, i.e., a private clinic located in Abidjan's Yopougon suburb., Results: A total of 32 cases of ectopic pregnancy were discovered by suprapubic and/or endovaginal ultrasound scan. The estimated frequency of ectopic pregnancy was 1.7%. Mean patient age was 26.2 years. The main risk factors were prior history of abortion (32%) and adnexal infection (20%). Most patients (52.5%) were nulliparous. The most frequent indication for ultrasound scan was metrorrhagia. Diagnosis of ectopic pregnancy was made at the ruptured stage in 65.6% of cases and nonruptured stage in 34.4%. The presenting lesions was hematosalpinx in 40.6% of cases and embryonate ectopic gestational sac in 31.3%. Salpingectomy and salpingorrhaphy were successful in 65.6% and 34.4% of cases respectivlely., Conclusion: In Abidjan, ectopic pregnancy involves young nulliparous women with a prior history of abortion and adnexal infection. Ultrasound allowed early diagnosis and, consequently, tube preservation in 34.4% of cases.

The purpose of this prospective study done from May to July 2007 was to show the interest of systematic chest X-Ray of future bus conductors. The main abnormalities were big heart, parenchymal lesion and pleural effusion.

The purpose of this study was to examine whether HIV infection affects either the echographic or laboratory profiles of renal insufficiency. This prospective study compared both echographic (kidney size, Hricak's cortical echogenicity grades) and laboratory (blood urea and creatine) profiles in two groups of patients with renal insufficiency: one group HIV-positive (25 cases) and the other HIV-negative (86 patients). Kidney size was generally normal in the HIV-negative group. In the HIV-positive group, it was either normal or enlarged, especially in thickness, with a spherical appearance. Echogenicity grades were high in both groups, and no HIV-positive patients were at grade I; 25.6% of the seronegative patients and 20% of seropositive patients were at grade II, and 57% and 68%, respectively, were at grade III. The correlation between ultrasound grades and laboratory results did not differ significantly between the two groups (p = 0.0669 for creatinemia and p = 0.0560 for uremia), although the rates tended to increase with echogenicity grade and were slightly lower in the HIV-positive group. The authors conclude that HIV infection does not seem to affect the ultrasound or laboratory profiles of renal insufficiency. Thickening of the kidney and any spherical aspect should however suggest to the practitioner that the renal insufficiency may be related to HIV.

The Authors report a rare case of praevia barrier from a duplex uterus (didelphys). A 30 Year old pregnant woman was admitted for ultrasound examination. Her past history included two cesarean sections with a stillborn infant in one case and a live infant with psychomotor retardation in the other case. Third trimester ultrasound examination was consistent with a 36-37 weeks gestation. A 9.1 by 5.8 cm retro-cervical praevia mass was also noted deep in the pelvis. The mass was similar in appearance to myometrium. Elective cesarean section performed at 38 weeks of gestation delivered a normal healthy 2950 g male infant and revealed a second non gravid uterus corresponding to the mass seen at ultrasound. Pelvic examination confirmed a diagnosis of uterus didelphys (uterus duplex bicornis bicollis with vaginal septum) separated by a sagittal partition. The post-operative course was uneventful. Praevia barrier by a half uterus in a patient with duplex uterus is a rare condition that can easily be detected by careful ultrasound examination thus preventing complications at delivery.

Unlabelled: The purpose of this study was to inventory the infrastructure and equipment available in Abidjan for paediatric radiology, identify the principal problems of radiological exploration of children and offer suggestions to improve it., Material and Methods: We identified the functional radiological material and the practitioners working in radiological services from 1 July through 31 December 1997. We also examined the records of all paediatric examinations performed during a one-year period in Yopougon University Hospital., Results: The population of Abidjan was estimated (by the National Institute of Statistics) at 3,323,214 in 1998, including 1,208,924 children (36%). There were 31 radiologists, that is, 1 per 101, 526 inhabitants, and 1 X-ray technician for 82,824 inhabitants. The equipment inventory revealed 1 ultrasound scan per 42,531 inhabitants, 1 standard imaging table per 112,403, 1 remote-control table per 242,000, 1 dental radiological system per 1,049,099, and 1 computed tomography system per 1,573,648. Children accounted for 17.4% (1836) of the 10,561 patients examined over one year at the teaching hospital, but there was no specific material for children's examinations., Conclusion: Neither human resources nor functional equipment are available in adequate numbers. Radiological equipment appropriate for paediatric exploration must be a priority in the future. .

To find out whether preventive antibiotic therapy can be justified in the practice of hysterosalpingography in a tropical environment where the infectious risk is notoriatly high, the authors performed a prospective study concerning 49 females patients. The patients in genital activity period, were willing and volunteers and were aged from 20 to 44 years. They were examined by hysterosalpingography during a period of three months. Patients were distributed in two homogenous group, one group of 25 patients who had a preventive antibiotic therapy and the second group with 24 patients with no preventive antibiotic therapy. Hysterosalpingography examinations were performed with sterile and single-use equipment. All patients were clinically examined for medical record purposes: gynaecologic, obstetric, pelvic infection, oral contraception, previous hysterosalpingography. Biologic dosages were realized, including blood count and erythrocyte sedimentation, culture of vaginal sampling, C reactive protein rate. The results obtained showed no significant difference between the two groups. The authors conclude that hysterosalpingography can be also performed in a tropical environment without using systematic preventive antibiotic therapy provided that asepsisrules are strictly observed.

The authors report a rare cause of pulmonary metastasis of a benign tumor, uterine leiomyoma, observed in a black African woman. Plain chest radiograph showed multiple pulmonary nodules. These features were confirmed at CT. Transbronchial and surgical lung biopsies were consistent with pulmonary metastases from benign uterine leiomyoma. Hormonal treatment was instituted and resulted in regression of nearly all lesions at one year. Benign metastazing leiomyoma is a rare condition, in spite of the high rate of uterine leiomyoma in black African women.

We investigated thyroid abnormality in Mauritania by carrying out a prospective ultrasound study of 171 patients. One hundred and thirty four patients underwent thyroid hormone determination (T3, T4 and TSH) and 123 had complementary plain film X rays of the chest and neck. These ultrasound examinations accounted for 3.8% of all ultrasound examinations performed over the study period. Thyroid abnormalities were more frequent in young adults aged 20 to 40 years (67.4%) and in women (83%) in Mauritania. Thyroid diseases affected people from savanna and mountain regions in particular. Diffuse goiters were the most frequent problem (76.3%) and most were multinodular or heterogeneous forms with necrosis or hemorrhage. One case of homogeneous diffuse goiter was found to be an infiltrating vesicular adenocarcinoma with metastatic adenopathy. Nodular goiters were mostly cystic, with septation (51.9%) and could be mistaken for hydatid cysts, which are endemic to the region. Further study of these aspects of thyroid diseases in Mauritania are required.

Pulmonary pleural staphylococcal infection is common in sub-Saharan Africa. It is rare in temperate zones and occurs in different epidemiological conditions. In African regions, very few staphylococcal infections are hospital-acquired, with most cases resulting from infection in everyday life. Pulmonary pleural staphylococcal infection typically affects infants. The frequency of neonatal forms is unknown. We describe here in the epidemiological, clinical and therapeutic characteristics of a case of pulmonary pleural staphylococcal infection in a newborn. The symptoms of our patient were typical, involving predominantly mechanical and hematological problems. The prevention of infection in very young children and early treatment of such infections could reduce the morbidity of this disease.

We report a case of a rare and particular cause of abdominal calcifications represented by the lithopedion. We describe different radiologic appearances observed by: abdominal plain film, echography and CT. It appeared to us that abdominal plain film alone is sufficient for diagnosis and undertaking surgery. Echography and CT are helpful, especially for complementary evaluation.

In this retrospective study, we define the localization and ultrasound appearances of hepatocellular carcinomas observed in Abidjan. The study included 31 inpatients (23 males and 8 females), aged from 24 to 76 years (mean, 47.4). All patients had serum alphafetoprotein dosage and 21 patients had cytologic examination. Diagnosis was based on a high level of serum alpha-fetoprotein (> 500 ng/ml), with or without cytological proof. Tumor characteristics (size, number, echogenicity, nodular or diffuse form) and associated extratumoral signs were noted. Ultrasound identified 19 cases of small tumors (size < 5 cm), and 12 large tumors (size > or = 5 cm). The tumor forms were mostly nodular and multiple (24 cases), solitary nodule (3 cases), diffuse or infiltrative (4 cases). The liver was heterogeneous with hyperechoic tumoral nodules (16 cases), hypoechoic tumoral nodules (5 cases), hyperechoic and diffuse form (4 cases), and 2 cases of mixed form. We have noted a particular form in 4 cases represented by a heterogeneous liquid-like mass simulating tropical abscesses. Ascites (12 patient) was the most common extratumoral sign. Portal vein invasion or thrombus was rare (3 patients). Of the 31 patients, ultrasound was abnormal in all cases, alpha-fetoprotein test was positive in 12 cases (57.14%) and negative in 9 cases (42.8%). Cytological test was positive in 17 cases (80.95%), and negative in 4 cases (19.04%). Alphafetoprotein and cytologic tests were both positive in 8 cases and, nonconcordant in 13 cases; in 4 cases alphafetoprotein was positive while cytological tests were negative and, in 9 cases alphafetoprotein was negative while cytological tests were positive. Two negative tests were never observed. In Abidjan, hepatocellular carcinomas are commonly small or large, multinodular and hyperechoic tumors contrasting with the small nodular and hypoechoic tumors usually reported in western series. Ultrasound associated with cytologic examination, appears to us to be more usefulness than alphafetoprotein dosage in the diagnosis of hepatocellular carcinoma.

Unlabelled: Renal pathologic changes in AIDS involve various factors and can also occur in several other forms of renal disease. Renal sonography was prospectively performed in 31 patients with laboratory evidence of AIDS and renal insufficiency. All patients included in this study were without clinical manifestations (group II of the CDC) and without risk factors of AIDS., Aim: to characterize renal pathologic changes underlying the sonographic findings in these patients. Sonographic evaluation included determination of renal sizes and renal echogenicity according to standard grading system. Sonography showed normal-sized or enlarge-sized kidneys. Enlarged kidneys were generally due to increased thickness rather than length or width; small-sized kidneys were not observed. Grading echogenicity showed: grade 0 in 3 patients, grade I in none, grade II in 11 patients and grade III in 17 patients. In six patients, we found "spotted" echostructural figure due to several hypoechoic and rounded zones. Echogenicity increased with the severity of renal insufficiency. Our study suggests that renal abnormalities are varied and can occur in all stages in the course of the disease. The particular "spotted" figure associated with enlarged size at the expense of thickness of kidneys must draw radiologist's attention to the probability of AIDS lesions. Further studies with large populations must be performed to confirm our observations.

Radiculography is used a great deal in our region and is often the only method available for examination of the lumbar spine. However, there has been little evaluation of the effectiveness of radiculography for lumbar diseases. To determine its value and indications in lumbar diseases we studied 322 patients who underwent radiculography. We studied 223 patients retrospectively and 99 patients prospectively. Radiculography had a sensitivity of 100%, a specificity of 86%, a positive predictive value of 92.7% and a negative predictive value of 100%. We found that the diagnostic accuracy of radiculography was higher if the examination was requested by a neuropathologist, if the patient had been ill for more than 2 months or had cauda equina syndrome, acute root pain, paralysis or debilitation. Such precise indications make it possible to avoid excessive examination and to make the best use of radiculography, particularly in areas without CT and MRI facilities. However, the examination should always be performed by a neuroradiologist or a physician with several years' radiculography experience.

Ultrasound scans were used to study 23 cases of abdominal contusion in children, between January 1992 and December 1993. Thirteen boys and 10 girls were studied. They were all aged between 4 and 14 years, with a mean age of 6 years. The main causes of their injuries were road accidents (12 cases) and play (11 cases). Ultrasound scans were normal in 6 patients and pathological in 17 patients. The most frequently observed injuries were visceral effects (12 cases), almost always associated with hemoperitoneum. In three cases, hemoperitoneum was detected in the absence of visceral effects. The spleen (4 cases) and the liver (4 cases) were the most frequently injured organs. The other injuries detected included renal hematoma, bladder rupture and parietal hematoma. Diagnosis on the basis of ultrasound scans was found to be incorrect in three cases where diagnosis was repeated after the scan. One case involved a blocked perforation of the rectum, one a benign cyst and the other a mesenteric cyst. Despite these misdiagnoses, ultrasound scanning is a highly sensitive and specific method for examination of contusions in children. It is very useful and often sufficient for accurate diagnosis, particularly in units with only modest technical support.

The different classifications used for amebic liver abscesses seem to be usually without direct therapeutic benefit. Echographic assessment was used to propose a new classification of amebic liver abscesses. This report is a prospective study conducted over 3 years and concerning 118 patients involved by 119 amebic liver abscesses. They were 109 males and 9 females aged from 13 to 68 years (mean, 36 years). All cases were correctly diagnosed by clinical and ultrasound findings, aspect of the pus, course under treatment and rarely by serologic examinations (3 patients). Patients were followed up with clinical and sonographic examinations as requested. Our classification was based on the initial echographic examination findings, the therapeutic indications and the type of healing obtained. In total, 93 abscesses (80, 67%) were treated by medical therapy alone and 26 cases (21, 84%) by combined US-guided evacuation and medical therapy. In the 119 abscesses, 112 (94, 11%) completely recovered with reconstitution of a normal liver parenchyma. In the remaining 7 cases (5, 88%) the abscesses persisted for several months (12 to 36 months). Our study suggests that ultrasonographic features of amebic liver abscesses can be segregated in three forms: noncollected form which needs to be treated by medical therapy alone, collected form which can be treated medically or by association with US-guided evacuation, and the healing forms. This classification appears to us to be simple but very precise, reliable and useful especially for therapeutic indications of amebic liver abscesses.

A prospective study of 100 newborns and young babies suffering from purulent meningitis was carried out over a period of 11 months in the radiology department of CHU in Treichville. All the children included in the study were hospitalised in the pediatric department of the CHU. We found cerebral complications in 76% of cases. The most frequent complication was ventricular dilation which occurred in 82.6% of cases. Pericerebral bleeding occurred in 9.3%, cerebral ischemia in 3.5%, brain abscesses in 2.3% and ventriculitis in 2.3% of cases. Our study demonstrated the two important uses of trans-fontanelle ultrasound scans in the study of meningitis: (i) in diagnosis, for the detection of cerebral complications; (ii) in treatment, interventional use of ultrasound makes it possible to evacuate intra-cranial septic fluids.

The abdomen in patients with acquired immunodeficiency syndrome (AIDS) is subject to various damage. In AIDS patients, manifestations in the retroperitoneal region, including apparent changes in the pancreas, kidney and lymph nodes, have been well described in the radiological literature. However, abnormalities of the vessels and perivascular spaces have not been well investigated in this syndrome. We performed abdominal sonography in 10 patients who were seropositive for HIV. They had no history of known risk factors such as drug abuse or homosexuality. Also, 4 healthy male controls were examined for comparison. Our aim was to demonstrate and to characterize the pathological changes of the retroperitoneal vessels and perivascular spaces from sonographic observations. The sonographic evaluation included determination of the morphologic and dynamic aspects of the aorta, vena cava and superior mesenteric vessels. The echostructure of the perivascular spaces was analyzed. In this prospective and preliminary study, we have not considered the presence of an AIDS condition. We have precisely analyzed the upper umbilical areas. In all cases, there were supposed to be the same landmarks. The sonographic scans were obtained through the left renal and mesenteric vessel areas, essentially through axial scans. In all 10 patients, sonography showed at least two abnormalities. Three patients had abnormal echostructural changes in all the sites. The images showed echostructural disorganization with poor definition and "fuzzy" and "dirty" aspects of the retroperitoneal vessels and perivascular spaces. The aorta was normal in 2 patients and abnormal in 8 patients with diminished hyperechography and regularity of the aortal wall. The aortic diameter was smaller than 1.5 cm in 7 cases, with a significant attenuation of the beating of the aorta. Despite these abnormalities, the aorta had a normal left paramedian position ahead of the rachis. The inferior vena cava was normal in 1 case and abnormal in 9 cases with diminished hyperechography and regularity of the wall. The vena cava position was normal in 4 cases, displaced in 6, and laminated in 3. The superior mesenteric vessels were abnormal in 8 cases, with poorly defined aims in 6, an indefinite position in 2, and spreading in 2. Adenopathy was present in 6 patients, multiple in 5 and singular in 1 case. A retrocaval location was always observed. A perivascular infiltration and thickening was noted which was diffuse in 6 cases and micronodular in 1 case. From our observations, we conclude that these echostructural changes could be related to AIDS. However, further studies are necessary to confirm these observations and to determine if this sonographic pattern may be seen during the course of the disease. This is the first study to our knowledge which stressed the echostructural changes of the retroperitoneal vessels and perivascular spaces in patients with AIDS.

Subcutaneous and soft tissue involvement is frequent in AIDS patients. Although the relevant clinical characteristics have been extensively described in the literature, there has been little work on the radiological features. We therefore report three cases of AIDS with subcutaneous and soft tissue involvement: two cases of pyomyositis and one case of non-Hodgkin's lymphoma. All three were black African men and were aged 22, 28 and 41 years. They were diagnosed as suffering from AIDS and were HIV1 and HIV2 positive. Diagnosis was established using needle puncture and histological (lymphoma) and bacteriological (pyomyositis) examination. We report ultrasound scan findings. The features of the pyomyositis differed from those usually observed in immunocompetent patients. The lymphoma nodules were similar to those described in the literature. They were hypoechoic and homogeneous, with no necrotic center. We believe that subcutaneous and soft tissue infectious involvement, for example pyomyositis, is more frequent in tropical regions than tumors (Kaposi's sarcoma, lymphoma) which are more frequent in Europe. This soft tissue involvement can be considered to be part of the particular picture which is "tropical AIDS".

Echography was prospectively performed in 345 black African female patients with pelvic masses which had been clinically detected in some cases. The women were between 11 and 65 years old. The aims of this study were to list the pelvic masses observed in black. African women, to record any potentially distinguishing features and to evaluate the sensitivity and the specificity of echography as applied here. A total of 477 masses were listed. Ovarian masses were the most frequent (56.66%) followed by uterine masses (31.45%). Most masses were benign. We observed only two cases of ovarian cancer. The sensitivity was 100% and the specificity was 97.69%. Eleven cases (2.3%) of the ultrasound diagnoses did not correspond with the final diagnoses. As for distinguishing aspects, these patients were younger than European patients-this was particularly true for patients with fibroid masses (a range of 31 to 40 years compared to 40 to 50 years). Genetic factors in these patients could explain the high rate and early appearance of fibroids. Because the diagnosis of vaginal masses is well established by clinical examination rather than by echography, this lesion was rarely observed. The most frequent clinical complaint was pelvic pain (36.94%), followed by pelvic mass impression (28.65%). We found high rates of both past histories of miscarriage and abortion (60.7%) and postabortion pelvic hematoma. The hematomas comprised 45.4% of the non-genital pelvic masses. Misdiagnosis of pyosalpinx was often a source of diagnostic error. Thus, to avoid false diagnoses of pyosalpinx in evaluating pelvic masses with a void in ultrasound, the possibility of an infectious episode should be evaluated by definitive questioning. Ultrasound examination is of value in evaluating the pelvic masses of women; however, this should be considered within the appropriate disease context.

Both clinical and radiologic manifestations can have unusual figures in patients with acquired immunodeficiency syndrome (AIDS). Infectious involvement, as in particularly tuberculosis, may simulate a neoplasm, and vice versa. We report a case of a tubercular pleuresy followed 14 months later by a lung cancer in a patient infected with the human immunodeficiency virus (HIV). This observation pose the delicate diagnostic problem of a recurred endobronchial tuberculosis we describe the chest roentgenograms and the computed tomography-scans patterns. We give the place of both of them. We call attention to the valuable rôle of the endobronchial endoscopy in the differential diagnosis between a recurrence of the tuberculosis or a lung cancer. This case demonstrate quite well that thoracic complications in AIDS are multiple and can be variable in the course of the disease. That command a definite exploration for an appropriate diagnosis and treatment.

Lumbar spine disease in Black Africans is poorly documented. Based on a series of 320 patients examined by myelography, the authors try to define the profile of lumbar spine disease in Black Africans in Abidjan. This disease is dominated by degenerative anomalies and a predominance of degenerative disk disease (54.20%) over disk herniation (33.33%). In contrast to the usual data of the literature, these lesions were essentially observed in subjects whose work required limited physical stress to the lumbar spine: variable postures and prolonged sitting. Neoplastic disease was marked by secondary lesions due to Burkitt's lymphoma. Paradoxically, infectious and parasitic disease and haemoglobinopathies were rare. Diseases such as nerve root anomalies and Tarlov's cyst were not observed in this series. Further studies in nonselected patients are necessary to more clearly define these data which suggest features specific to Black Africans compared to the data generally reported in the literature.