The aim of this study was to compare the epidemiology of rheumatoid arthritis (RA) in North Africa to that of Western countries. We have enrolled in a cross-sectional study all consecutive patients presenting with the diagnosis of RA according to the 1987 ACR criteria, and during a 5-month period, patients were included in 11 centers across northern Algeria. Demographics, clinical data, and health assessment questionnaires (HAQ) were collected for each patient. We have estimated means, standard deviations, and 95 % confidence intervals for all parameters. Of the 249 patients (213 females and 36 males) enrolled in the study, 10 (4 %) had juvenile onset of the disease. The mean age was 50.1 ± 14.5 years, and the mean duration of RA was 8.4 ± 7.8 years. In terms of comorbidities, 18.9 % of patients reported hypertension and 5.2 % had diabetes. The mean DAS28 at inclusion was 4.3 (95 % CI 4.1-4.5); 14.0 % were in remission (DAS28 ≤ 2.6). The mean HAQ score was 0.81 ± 0.82. Rheumatoid factor was positive in 78.5 % of cases, and anti-citrullinated protein/peptide antibodies, when measured, was positive in 69.0 % of cases. Seronegative patients were older and had a relatively less severe disease. For treatment, 89.7 % of patients were taking disease-modifying anti-rheumatic drugs and only 4 % were taking biologics (rituximab); 90.8 % of patients were taking glucocorticoids, and none of the patients satisfied the recommended calcium intake guidelines. RA in Algeria is more common in women. Compared to reports from Western countries, RA in Algeria appears to be less aggressive, with more dominant seronegative oligoarthritis forms. The remission rate is comparable to that of Western populations.

We present a 35-year-old male, who initially complained of progressive and persistent inflammatory back pain for 2 years, which was diagnosed as a T12 thoracic spine osteoid osteoma. The patient underwent intralesional resection of the tumor via a posterior approach, with immediate post-operative pain relief, and 2 years of pain-free spine interval. Recently, the patient presented with an inflammatory back pain. Visual Analogic Scale (V.A.S) was 7/10 and stiffness,The Back Pain Functional Scale (BPFS) was 30/60, suggesting a recurrence of the spinal Osteoid Osteoma (OO), diagnosis ruled out giving the negativity of the spine MRI and CT scan. Therefore, an ankylosing spondylitis was suspected, hence, sacroiliac joints MRI was performed, depicting an active bilateral sacroiliitis, confirming the diagnosis of AS according to ASAS criteria. The aim of this paper is to point out similarities between OO and AS and their clinical and probable therapeutic implications. Though few cases of their association have been reported in the literature, both of bone osteoblastic tumors and Ankylosing Spondylitis (AS) share a number of common features, which let us assuming a possible relationship and therefore, the necessity to assess for sacroiliitis in patients with osteoid osteoma. Differential diagnosis should be considered especially in patients with inflammatory back pain. Moreover, a purely pharmacological approach to the management of OO by the use of biological agents may be considered.

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