Early Identification of Sacroiliitis in Patients with Suspected Spondyloarthritis: A Challenging Task.

Objective: The purpose of this study was to assess the performance of computed tomography (CT) scan and magnetic resonance imaging (MRI) for detecting sacroiliitis in nonradiographic SpA (nr-SpA).

Methods: This cross-sectional monocentric double-blind study included 63 patients consulting for symptoms suggestive of SpA between February 2014 and February 2017. Patients with conventional radiographs showing a confirmed sacroiliitis (grade 3 or 4) were not included.

Contribution of Ultrasonography of Hands and Wrists in Early Rheumatoid Arthritis.

Objectives: Early diagnosis and management of rheumatoid arthritis (RA) have improved the outcome of patients. In the last decade, musculoskeletal Ultrasonography (MSUS) had demonstrated its superiority over clinical examination in detecting synovitis in RA. We conducted this present study in order to assess the added value of MSUS in diagnosing early RA.

About a knee pain.

A beautiful 28-year-old female patient, 1.77 meters long, was referred to us after mammoplasty for mechanical knee pain. Below, her X-rays of the pelvis and the two knees.

Assessment of fracture risk in patients with spondyloarthritis using the FRAX scores.

Introduction: Osteoporosis and fractures are known to complicate spondyloarthritis (SA). The Fracture Risk Assessment Tool (FRAX) estimate the 10-year probability of major osteoporotic fracture (MOF) and also hip fracture (FH). It can be useful as risk assessment tools for the purpose of preventing fracture in SA.

Contribution of bone mineral density in stress fractures of elite athletes.

Introduction: The stress fracture occurs in a healthy bone with a lack of adaptation to sustained, intensive and repetitive physical activity. However, bone mineral density is strongly correlated with bone strength and fractures may occur more easily on osteoporotic bone.

Aim: To evaluate the bone densitometric profile of elite athletes with a history of stress fracture and to determine the interest in preventing this type of fracture.

Safety and efficacy of tocilizumab as monotherapy or in combination with methotrexate in Tunisian patients with active rheumatoid arthritis and inadequate response to disease-modifying anti-rheumatic drugs in conditions close to clinical practice.

Objectives: We aimed to assess the safety and efficacy of tocilizumab as monotherapy or in combination with methotrexate in a routine clinical practice setting in Tunisian patients with RA who did not respond to conventional treatment with disease-modifying anti-rheumatic drugs (DMARDs-IR).

Method: A total of 51 DMARDs-IR adult patients with moderate to severe RA participated in a phase IIIb, open-label clinical trial. Patients received 8 mg/kg of tocilizumab every 4 weeks in combination with a DMARD or as monotherapy during 24 weeks.

Multiple brown tumors revealing a parathyroid adenoma. About 2 cases.

A brown tumor is a rare complication of hyperparathyroidism. Its circumstances of discovery are multiple and its symptoms are nonspecific. We report here two cases with deceptive forms of multiple brown tumors discovered in patients with bone pain.

[Sacred sacrum!].

Post-fracture osteolysis of the sacrum is a rare radiological entity mimicking a serious disease. We report the case of a female patient lost to follow-up after biopsy indication. She presented again after 4 months.

Epiphyseal pseudotumor of the tibia:an uncommon presentation of osteoarthritis.

Epiphyseal pseudotumor secondary to osteoarthritis are rare in patients under 50 years. We report here the case of a 48-year-old woman who complained of pain in the medial side of the left knee for three years. X-rays of the left knee showed a large lytic lesion containing multiple septae, with sclerotic margins at the upper end of the tibia, associated with knee osteoarthritis.

Uncommon etiology of knee pain: Lipoma arborescens.

Unlabelled:  Lipoma arborescens is a rare intra-articular benign tumor. It affects mostly the knee and the diagnosis is usually difficult due to resembling symptomatology of osteoarthritis.

Cases Presentation: We report herein 3 new cases of lipoma arborescens of the knee in which a patient has synovitis associated.

About an aggressive bone lesion.

We report here a case of hyperparathyroidism with disseminated brown tumors mimicking malignancy. The important clinical teaching of our case is that hyperparathyroidism can take various aspects. Plasma parathyroid hormone concentration should be measured in all patients with multiple bone lesions.

Health-related Quality of Life Assessment on 100 Tunisian Patients with Ankylosing Spondylitis using the SF-36 Survey.

Objectives: The main objective of the study was to examine the self reported health status in patients with ankylosing spondylitis (AS) compared with the general population and the secondary objective (in the AS group) was to study the association between health status, demographic parameters, and specific disease instruments in AS.

Methods: A cross sectional study of 100 AS patients recruited between 2006 and 2009 at the Department of Rheumatology. Health status was assessed by using the SF-36 health questionnaire in patients with AS.

[Clinical, radiographic and biologic particularities of ankylosing spondylitis in Tunisian patients according to the presence or the absence of the HLA B27 and its sub-types].

To assess the clinical, radiographic and biologic particularities of ankylosing spondylitis (AS) in Tunisian patients according to HLA B27 and its sub-types statute. This was a case-control study that included 100 patients (85 males/15 females) with AS according to the modified New York criteria. Demographic, clinical, AS specific indexes, radiographic and biologic parameters were determined.

[Validation of the Ankylosing Spondylitis Quality of Life questionnaire in Tunisian language].

Background: The Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire is a Wide-world used, unidimensional, disease-specific measure of quality of life. Arabic or Tunisian versions of ASQoL or any other quality of life index are not provided.

Aim: To adapt the Ankylosing Spondylitis Quality of life Questionnaire (ASQoL) for use in Tunisian and to test its reliability and validity.

Assessment of preclinical atherosclerosis in patients with ankylosing spondylitis.

Objective: Epidemiological studies recently confirmed the increased risk of vascular morbidity and mortality during ankylosing spondylitis (AS). Increase of intima-media thickness (IMT) of the common carotid artery is a useful and noninvasive marker of preclinical atherosclerosis. The aim of our study was to compare IMT in patients with AS with matched controls and to determine risk factors of atherosclerosis related to AS.

Performance of ultrasounds compared with radiographs to detect chronic enthesitis signs in patients with ankylosing spondylitis.

To assess the performance of ultrasound in detecting erosion, swelling, and new bone comparing to radiographs in five lower limb entheses in patients with ankylosing spondylitis (AS). Prospective study of 60 patients meeting modified New York criteria for AS. Lateral radiographs of both knees and ankles followed by a high-resolution Doppler ultrasound examination with a high-frequency (15 MHz) linear probe were performed.