[Contribution of dynamic radiographs in atlantoaxial subluxation in rheumatoid arthritis].

Background: Cervical spine (CS) involvement is common during rheumatoid arthritis (RA) and it is distinguished by its potential gravity.

Aim: To determinate the occurrence of atlantoaxial subluxation (AAS) by dynamic incidences X-Ray and to assess its predictive factors.

Methods: Our study included a cohort of 40 patients carrying RA, who fulfilled the American College of Rheumatology criteria, for more than 2 years.

[Survival prognosis factors in multiple myeloma].

Background: Outcome in multiple myeloma (MM) is very heterogeneous in survival and therapeutic response, constantly fatale despite her therapy progress.

Aim: To determine the prognostic factors and survival in MM.

Methods: We carried out a transversal study of 100 patients in the rheumatology department of hospital Monastir between 1991 and 2010.

[The role of biochemical markers of bone turnover in the diagnosis of osteoporosis and predicting fracture risk].

Background: Currently, for the diagnosis of osteoporosis, we search risk factors and measure bone mineral density (BMD) by DXA method. However, bone turnover markers, unused still in practice, have shown an interest especially in the prediction of fracture risk. aim: To determine the relationship between bone markers, BMD and osteoporotic fracture.

[Prevalence of bone loss in adult celiac disease and associated factors: a control case study].

Background: Bone loss in celiac disease (CD) is important and is associated to increased risk of fractures. The determining factors of this Bone loss and the osteoporosis fracture during this disease remain still unknown. The bone remodeling parameters seem to play it an important role.

Lipid profile in Tunisian patients with rheumatoid arthritis.

This study aims to assess the prevalence of dyslipidaemia in Tunisian patients with active RA and to investigate the clinical and biological associated factors. A cross-sectional study was conducted on 92 unselected patients with active RA (77 females and 15 males, aged 49.1 ± 12.

[Ochronosis: report of two familial cases].

Background: Ochronosis of alkaptonuria is a rare hereditary autosomal recessive disease in which there is an absence of homogentisic acid oxidase resulting in accumulation of homogentisic acid in tissues.

Aim: To report a new case of alkaptonuria

Case Report: A 49-year-old man had been followed for 4 years for chronic lombalgia and arthropaty of two knees. He is married to his cousin and father of 4 girls.

[The fracture risk assessment tool (FRAXTM), where are we in Tunisia?].

Background: The fracture risk assessment tool (FRAXTM), published in February 2008, is developed based on the use of clinical risk factors with or without bone mineral density tests.

Aim: To calculate the FRAX tool in a cohort of Tunisian patients in whom bone mineral density (BMD) was assessed by dual X ray absorptiometry (DXA); to correlate this score to osteoporotic fracture and to BMD assessment and to propose a threshold for therapeutic intervention.

Methods: In a cross sectional study of 582 patients older than 40 years, in whom a BMD measurement by DXA has been performed between January 2006 and December 2009, clinical risk factor for osteoporotic fracture and the occurrence of a prior fragility fracture were assessed.

[Safety of rheumatic disease drugs at childbearing age].

The aim of this study is to determine the safety of commonly prescribed antirheumatic drugs at childbearing age, in pregnancy and lactation, through systematic literature review. Patients who take cytotoxic drugs should be informed of the risks of impared fertility. During pregnancy, non steroidal anti-inflammatory drugs (NSAIDs) can be safely administered until gestational week 32.

The impact of pregnancy on rheumatoid arthritis outcome: the role of maternofetal HLA class II disparity.

Objectives: To investigate the influence of pregnancy and postpartum on rheumatoid arthritis (RA) course and the impact of maternofetal HLA class II disparity.

Methods: In 13 women with RA, disease activity was assessed prospectively, before and every three months throughout pregnancy and after delivery until one year in postpartum. The HLA class II disparity was evaluated by typing HLA-DRB1, DQB1 and DQA1 alleles by the PCR-SSOP for 12 couples mothers and babies.

Socioeconomic impact of ankylosing spondylitis in Tunisia.

Objective: Ankylosing spondylitis (AS) is the second most common chronic inflammatory joint disease after rheumatoid arthritis and causes substantial functional impairment, two features that generate a heavy socioeconomic burden. Here, our objective was to assess the socioeconomic impact of AS and to identify factors associated with higher costs.

Patients And Methods: We retrospectively reviewed the medical charts of 50 patients with AS seen at the Monastir Public Health Service Hospital over the 6-month period from March to September 2006.

An autosomal dominant hypophosphatemic rickets phenotype in a Tunisian family caused by a new FGF23 missense mutation.

Autosomal dominant hypophosphatemic rickets (ADHR) is a rare disease, characterized by isolated renal phosphate wasting, hypophosphatemia, and inappropriately normal 1,25-dihydroxyvitamin D(3) (calcitriol) levels. This syndrome involves rickets with bone deformities in childhood and osteomalacia, osteoporosis, articular and para-articular pain, and fatigue in adulthood. It is caused by mutations in a consensus sequence for proteolytic cleavage of the FGF23 protein.

[Usefulness of ultrasonography for the diagnosis of carpal tunnel syndrome].

Background: Ultrasound is an emerging tool in the diagnosis of carpal tunnel syndrome (CTS). THE AIM of this study is to evaluate the diagnostic role of ultrasound n the CTS.

Methods: Twenty five patients with signs and positive electromyographic of CTS were evaluated with ultrasound.

Prevalence of subclinical amyloidosis in Tunisian patients with rheumatoid arthritis.

Introduction: Secondary amyloidosis is a serious complication of rheumatoid arthritis (RA). Symptoms are late to occur, so that screening is in order, most notably in patients with long-standing RA. The objectives of our study were to determine the prevalence of subclinical amyloidosis in RA patients by abdominal fat aspiration biopsy (AFAB) and minor salivary gland biopsy (MSGB) and to identify factors associated with subclinical amyloidosis.

Compared imaging of the rheumatoid cervical spine: prevalence study and associated factors.

Introduction: Cervical spine involvement is common and potentially severe in patients with rheumatoid arthritis (RA). The objectives of this study were to compare the prevalences of cervical spine abnormalities detected by standard radiography, computed tomography (CT), and magnetic resonance imaging (MRI) in patients with RA; and to identify factors associated with cervical spine involvement.

Methods: We studied 40 patients who met American College of Rheumatology criteria for RA and had disease durations of 2 years or more.

Complete reversal of tumoral calcinosis after subtotal parathyroidectomy in a hemodialysis patient.

Introduction: Tumoral calcinosis is a rare complication of chronic hemodialysis whose mechanism is incompletely understood. The treatment is challenging and should target the main precipitating factors, most notably secondary hyperparathyroidism and calcium-phosphate (Ca x P) product elevation.

Case Report: In this 41-year-old patient, tumoral calcinosis developed in the right hip and subacromial bursa of the right shoulder after 3 years of chronic hemodialysis.

[Inpatients satisfaction in a rheumatology department].

Material And Methods: This prospectivve study aiming to evaluate patients satisfaction included 102 patients (42 men and 60 women with a mean age of 49.7 years) admitted in the department of rhumatology of Monastir University hospital, and was based on a validated questionaire.

Results: Global satisfaction was 80%.

[Search for crystals in synovial fluid].

Synovial fluid analysis is a very important diagnostic procedure in rheumatology. Cell count allows the differentiation ting between inflammatory arthritis, in which cell count exceeds 2000 cells/mm3, and non inflammatory arthropathy, in which cell count is less than 1000 cells/mm3. Demonstration of crystals in synovial fluid is a rapid and inexpensive way to diagnose microcrystalline arthritis.