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Background Systemic sclerosis (SSc), an autoimmune disease, has endothelial dysfunction and tissue fibrosis. The lack of its specific activity markers urges the research. Endocan is an immunomodulatory protein associated with endothelial dysfunction. We aimed to measure of the endocan level in systemic sclerosis (SSc) patients’ sera to test its relation to disease activity and treatment responses. Also, to evaluate its specificity by comparing these data with Behçet’s disease (BD) and rheumatoid arthritis (RA) patients’ data. Results SSc and RA patients were in activity but in the BD group; eight were active and seven were inactive. The endocan level was higher in the three groups in comparison to the controls without statistically significant differences (p value RA 0.697, SSc 0.063, and BD 0.196). A statistically significant difference in endocan levels between SSc patients with and without vascular manifestations (pulmonary hypertension and finger pitting ulcers, p < 0.0001, p = 0.0097, respectively). There were no significant correlations between endocan level and the erythrocyte sedimentation rate and C-reactive protein (positive rheumatoid factor for RA) in the three groups (p > 0.05). There were no significant correlations between endocan level and activity scores in the three groups (p > 0.05). The cut-off value of endocan was 1.3 ng/ml. Conclusion Endocan is a non-specific marker for the vascular pathogenesis in systemic sclerosis but not a good predictor for its activity.

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Rheumatoid arthritis (RA) is the most prominent systemic autoimmune rheumatic disease that may affect different tissues and organs, although the synovial joints represent the major target, The aim of this study is to assess the effect of BMI on rheumatoid arthritis disease activity and evaluate the differnce between clinical and ultrasound assessment of the Disease Activity Score in 28 joints (ΔDAS28) in 3 BMI subgroups according to the WHO classification. Methods: A cross-sectional study was conducted on 52 randomly selected, age & sex matched RA patients diagnosed according to ACR/EULAR 2010 classification criteria of RA, All patients was subjected to full history taking, complete clinical examination, laboratory assessment and Musculoskeletal Ultrasonography. Results and conclusion: Effect of BMI on the disease activity of RA; clinically: there were no significant difference in DAS28 between the normal weight, overweight, and obese patients. But there was a significant difference in swollen joint count between the three BMI groups. Comparison between clinical assessment and musculoskeletal ultrasonography in the three BMI groups ; Musculoskeletal ultrasound is better than clinical examination to detect synovitis in all BMI groups. There were significant differences between swollen joint count and grey scale in normal weight, overweight and obese patients. P value = 0.025, < 0.001 and 0.003 respectively. Musculoskeletal ultrasound is better than clinical assessment to detect the disease activity score in 28 joints (DAS 28) in overweight and obese patients.

Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of inflammatory arthritis of unknown etiology in children with impending risk of impaired joint function. It is defied by the presence of at least one inflamed joint persisting 6 weeks with the onset before 16 years of age. The aim of this study was to determine the extent and pattern of cervical spine involvement in children with JIA using plain radiography. Methods: This study was carried on 50 JIA patients together with 20 age and sex matched apparently healthy volunteers representing a control group. Patients were subjected to history taking , full clinical examination, disease activity was measured using Juvenile Arthritis Disease Activity Score-27(JADAS-27) and X-ray was done to assess cervical spine involvement and Atlanto-Dens interval (the distance between anterior arch of atlas and the dens of axis) (ADI) was measured. Results: Cervical curve was straightened in 60% of patients' group. Intervertebral discs, retropharyngeal spaces, Spinolaminar line alignment and ADI measurements were normal in all cases. JIA patients of polyarticular type, had a higher incidence of neck pain and neck stiffness (P value = 0.798). There were no statistical significant difference regarding ADI measurements in JIA patients suffering from neck pain and neck stiffness (P value = 0.984). Conclusion: Neck pain & stiffness were more frequent in Polyarticular JIA patients than oligo articular or systemic onset type. No radiological abnormalities were detected between different types of JIA.