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.

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.

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.

[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.

[Rheumatologic manifestations of sarcoidosis].

Sarcoidosis is a systemic granulomatous disease of unknown etiology. It has various clinical features. The most commonly affected organs are the lung, the lymph nodes, the eyes and the skin.

Correlations among clinical, radiographic, and sonographic scores for enthesitis in ankylosing spondylitis.

Objectives: To look for correlations among clinical, radiographic, and sonographic scores for enthesitis in patients with ankylosing spondylitis (AS).

Methods: Prospective study of 60 patients meeting modified New York criteria for AS. The clinical evaluation relied on the BASDAI, BASFI, and ASQoL and on a visual analog scale (VAS) for entheseal pain, as well as on two specific enthesitis indices, the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and the Spondyloarthritis Research Consortium of Canada Enthesitis Index (SPARCC).

Noncontiguous multifocal spondylitis: an exceptional presentation of spinal brucellosis.

Aim: The aim of this study was to describe the imaging features of multilevel brucellar spondylitis and discuss the diagnostic challenges

Case: The authors report describes one case of noncontiguous synchronous multifocal involvement of thoracic and lumbar spine.

Results: Brucellosis is a zoonosis of worldwide distribution, relatively frequent in Mediterranean countries and in the Middle East that can involve many organs and tissues. The spine is the most common site of musculoskeletal involvement, but multilevel involvement is uncommon and only ten cases were reported in literature.

Validation of the Tunisian versions of Bath Ankylosing Spondylitis Functional Index (BASFI) and Disease Activity Index (BASDAI).

Background: The Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity (BASDAI) are the most commonly used instruments to evaluate respectively functioning and disease activity in ankylosing spondylitis (AS).

Objective: The aim of this study was to translate, adapt and validate these instruments into the Tunisian language.

Methods: The studied population consisted of 68 AS patients (59 males and 9 females).

HLA-B, DR and DQ antigens polymorphism in Tunisian patients with ankylosing spondylitis (a case-control study).

The objective of the study is to assess the distribution of HLA-B genes, HLA-B27 subtypes, HLA-DRB1 and HLA-DQB1 alleles in patients with ankylosing spondylitis (AS) and in control subjects in the Tunisian population and to compare their distribution with that found in other countries. This is a case-control study that included 100 consecutive patients (85 males/15 females) with AS according to the modified New York criteria and 100 control individuals. HLA-B, B27 subtypes and class II (DR and DQ) typing of all subjects was performed by polymerase chain reaction amplification with sequence-specific primers (PCR-SSP).