Atypical vertebral Paget's disease.

A 40-year-old Mauritanian man consulted for back pain. A computed tomography of the spine showed patchy sclerosis of the fifth and seventh thoracic vertebral bodies with normal neural arch of T5 and sclerosis and hypertrophy of the neural arch of T7, as well as diffuse sclerosis of the T11 vertebral body with a normal neural arch. At MRI, low signal-intensity on T1-weighted images and high signal-intensity on T2-weighted images involved the whole T5 and T7 vertebrae and the vertebral body of T11.

[Indications of anakinra].

The efficacy of anakinra on both RA-related symptoms and structural damage has been demonstrated in several randomized controlled trials. However, its interest seems limited with regards to other biologic agents. Anakinra seems promising in the treatment of childhood or adult onset Still disease, after the failure of both high dose steroids and methotrexate.