BackgroundBy aging, many changes occur in the different components of the locomotor system, leading to a pathological situation such as osteoarthritis or remaining totally asymptomatic.ObjectivesThe aim of the current study was to compare,via ultrasound, the entheseal changes in two groups of people having different ages by calculating a modified Madrid sonography enthesitis index.MethodsThe study was conducted in the rheumatology department of Mongi Slim hospital in Tunisia, between June 2015 and December 2016, including 17 healthy subjects. We indentified two groups: (G1) 9 persons aged >50 years [51–68] and (G2) 8 persons aged ≤50 years-old [37–50].All the included persons underwent an enthesis ultrasound exploration (EsaoteMyLab 60 machine and a 13–18 MHz linear array transducer) by a rheumatogist experimented in ultrasound. Five enthesis locations bilaterally (distal Achilles tendon, distal andproximal patellar ligaments, distal quadriceps, and brachial triceps tendons) in each person were explored.The following elemental lesions of enthesis were evaluated: thickness, presence of calcifications, erosions,enthesophyte, loss of fibrillar patternand power Doppler signal.The calculated index was compared by Mann-Whitney U test between cases and controls. The significance level was set at 5%.ResultsIn our study population, the median age was 51.8±2.3 years and the median body mass index was 30±1 kg/m2. This last was similar between the two groups. All included subjects were female.The total enthesitis index was higher in G1 (6.67±0.91)than G2 (3.50±0.73) with a statistically significant difference (p=0.01).Considering each evaluated enthesis, the distal patellar ligament score was significantly higher in the G1 (1.67±0.55 vs 0.25±0.16 with p=0.03). For the other enthesis, there was no significantly difference between the 2 groups.ConclusionsThe distal patellar ligament enthesis changes shown in older persons may be the traduction of a silent-stage of knee osteoarthritis.Disclosure of InterestNone declared
BackgroundRheumatoid arthritis (RA) is the most frequent chronic inflammatory rheumatism. The DAS 28 is a disease activity measure method used to assess RA activity. It is a composite score taking into account 4 items: the number of swollen joints/28, the number of tender joints/28, the erythrocyte sedimentation rate (ESR) or C reactive protein (CRP) rate, the patient global assessment (PGA) indicated on a 0–10 cm visual analogue scale (VAS) with ‘not active at all’ and ‘extremely active’ as anchors. The DAS28 determination is very important since it guides the therapeutic decision.ObjectivesThe aim of this study was to determine the different ways of asking about the PGA and to assess the impact of its value variation on the calculation of the DAS 28.MethodsIn order to determine how to evaluate the GPA, a questionnaire including 4 propositions was asked to a cohort of Tunisian rheumatologists:how do you assess your health status this past week?what is the degree of the disease impact in your life this last week?what is the degree of the disease activity this last week?otherThen, a DAS 28 calculation was proceeded according to the different choices of GPA question method for 10 Tunisian patients.ResultsThe questionnaire was proposed to 37 rheumatologists, 15 working in the private sector and 22 in the public sector. These latter were 9 assistants, 3 professors, 5 specialist doctors and 5 associate professors. The first, second, third and fourth propositions were respectively chosen by 2, 14, 19 and 2 physicians. Subsequently DAS 28 was calculated. In the table 1 below, the variation of the DAS 28 value according to the choice of the PGA method is shown:Abstract AB0254 – Table 1PatientDAS 28(PGA1)DAS 28(PGA2)DAS 28(PGA3) DeltaDAS 28(DAS28 max-min) 12.952.952.810.1422.532.672.670.1432.11.961.960.1445.825.825.540.2855.305.305.160.1462.872.872.870.0078.228.228.220.0084.975.115.110.1497.497.357.630.14102.032.171.890.28ConclusionsThe GPA question is a subjective item taken into account for the calculation of the DAS 28. Despite the different ways of asking about it, our study showed that this factor have no real impact on the DAS28 value variation since it doesn’t exceed 0.6. DAS28 remains a reliable tool in the clinical practice.Disclosure of InterestNone declared
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