BackgroundJuvenile idiopathic arthritis (JIA) groups several entities having in common the presence of arthritis that begin before the age of 16, persist for more than six weeks and have no identified cause.ObjectivesThe aim of our study was to determine the feature of the different clinical forms of JIA.MethodsThis is a retrospective study of 54 cases of JIA according to the criteria of the International League Association of Rheumatology in department of Rheumatology collected over a period of 16 years [1998-2014].ResultsOur population consists of 28 men and 26 women (sex ratio of 1.12). The average age of symptoms onset was 10.4 years [4-15 years]. Late diagnosis in adulthood was noted in 8 patients (15% of cases). The polyarticular form was the most common, affecting 66% of cases (15.1% with rheumatoid factor and 50.9% without rheumatoid factor). The other forms were in descending order: oligoarticular form (15.1%), arthritis with enthesitis (9.4%), systemic form (7.6%) and psoriatic arthritis (1.9%). Stunting and hip disease were observed respectively in 30.2 and 32.1% of cases. Extra- articular signs were fever (18.9%), uveitis (3.8%), pericarditis (3.8%), pleurisy (1.9%), rash (1.9%), peripheral lymphadenopathy (1.9%) and myocarditis (1.9%). The treatments used were: corticosteroids (66%), non steroidal anti-inflammatory drugs (43.4%), aspirin (17%), methotrexate (47.2%) and biotherapy (anti-tnf alpha) (9.4%).ConclusionsJIA is an heterogeneous group of diseases having in common the presence of arthritis. Our series is characterized by the prevalence of hip disease. The treatment depends on the form of the disease.Disclosure of InterestNone declared
BackgroundThe infectious spondylodiscitis is the location of a microbial agent to the body of the vertebra associated with disc disease. It is called multifocal when the spinal involvement of several floors is not contiguous. It is seen especially in immunocompromised patients.ObjectivesThe objective of our study was to describe the clinical, biological, radiological and therapeutic aspects of multifocal infectious spondylodiscitis.MethodsThis is a retrospective study of 84 cases of infectious spondylodiscitis collected in department of Rheumatology over a period of 15 years [1999-2014]. Multifocal infectious spondylodiscitis was observed in 6 cases.ResultsOur population consists of 4 men and 2 women. The mean age was 52 years [36-64]. One patient was diabetic. The tuberculous origin was retained in 5 cases and the Brucella origin in one case. The mean disease duration was 5 months [1-12 months]. The start mode was progressive in all cases. The circumstances of discovery were inflammatory spinal pain in all cases associated to general signs such alteration of the general state and night sweats in 5 cases. Radicular pain was observed in 4 cases. Motor deficit was objectified in 4 cases. An array of spinal compression occurred in 2 cases. The biological inflammatory syndrome was observed in all cases. X-ray showed disc space narrowing in 6 cases and erosion of the vertebral endplates in 3 cases. MRI performed in 5 cases showed a typical appearance of infectious spondylodiscitis in all cases, an epiduritis in one case, an infiltration of the soft parts in 5 cases and spinal cord compression in 2 cases. Spondylodiscitis interested lumbar spine in one case, thoracic and lumbar spine in 3 cases and lumbar and cervical spine in 2 cases. All patients benefited of disco-vertebral puncture biopsy. Histological examination was specific for tuberculosis in 3 cases. The tuberculous origin was retained in 2 cases based on clinical and radiological data. The Brucella serology was positive in one case. All patients with tuberculous spondylodiscitis were put on anti tuberculosis treatment. The patient with brucella spondylodiscitis was put on association of cyclin and rifampicin. The evolution was unfavorable in one case with persistence of neurological sequelae.ConclusionsMultifocal infectious spondylodiscitis can occur in immunocompetent individuals. The causative organisms are dominated by tuberculosis. Treatment should be initiated as soon as possible to avoid neurological sequelae especially.Disclosure of InterestNone declared
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