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Background Ankylosing spondylitis is one of the most common inflammatory rheumatic diseases and is associated with alterations in posture. The aim of this study was to investigate the pedobarographic changes among ankylosing spondylitis patients, in an attempt to understand whether the alterations in the posture affect the plantar pressure distribution. Methods The study population consisted of 38 patients with ankylosing spondylitis and 33 healthy volunteers. The static and dynamic pedobarographic measurements were performed to determine the plantar pressure distribution. Moreover, the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Questionnaire and Bath Ankylosing Spondylitis Metrology Index were used to assess the clinical state of the patients. Results The static pedobarographic measurements did not reveal any intergroup difference. There were differences between the groups in the results of dynamic peak pressure measurements under the metatarsal areas and under the midfoot region. The percentage of the midfoot in the dynamic plantar contact area was higher in ankylosing spondylitis patients in comparison to the controls. No clinically significant correlation was found between the clinical scores and static pedobarographic measurements. The plantar pressures under the metatarsal heads, medial and lateral heel regions declined with increasing disease activity according to the Bath Ankylosing Spondylitis Disease Activity Index scores. The lower peak pressures on the forefoot and rearfoot, were associated with the higher Bath Ankylosing Spondylitis Metrology Index scores of the patients. Interpretation The alterations in the posture may have effects on the plantar pressures in patients with ankylosing spondylitis, especially during dynamic activities.

Resume Objectif Etudier l’importance de l’enthesite et sa correlation avec les parametres cliniques et la qualite de vie chez les patients atteints de spondylarthropathie (SA). Methode Cent dix-huit patients repondant aux criteres de classification du groupe europeen d’etude des spondylarthropathies (ESSG) ont ete inclus dans cette etude. Les parametres cliniques suivants ont ete evalues : la raideur matinale, les douleurs au repos, les douleurs au cours de l’activite physique et le nombre d’articulations gonflees et douloureuses. Les enthesites etaient evaluees par le Mander Enthesis Index (MEI). La qualite de vie etait mesuree par le questionnaire generaliste SF-36. Resultats L’incidence ainsi observee de l’enthesite chez les patients atteints de SA etait de 84 %. Une correlation significative etait retrouvee entre la raideur matinale, la duree de la maladie, les articulations douloureuses et six des dimensions du questionnaire SF-36. La plus importante correlation etait observee entre le MEI et le nombre d’articulations douloureuses (p Conclusion L’enthesite est couramment observee parmi les patients atteints de SA. Elle affecte negativement la qualite de vie des patients.

Objective To investigate the involvement of enthesis and its correlation with clinical and quality of life parameters in patients with spondyloarthritis (SpA). Methods One hundred and eighteen patients who comply with the SpA classification criteria of the European Spondylarthropathy Study Group (ESSG) were included into the study. Clinical parameters such as morning stiffness, rest pain, activity pain, tender joints and swollen joints were evaluated. Enthesitis were assessed by Mander Enthesis Index (MEI). The quality of life was assessed by Short Form-36 (SF-36). Results The incidence of enthesitis in patient with SpA was found at a rate of 84.9%. There was a significant correlation between MEI and morning stiffness, disease duration, tender joints and six subgroups of SF-36. The highest correlation was found between MEI and number of tender joint ( p Conclusion Enthesitis is commonly seen among patients with SpA. Enthesitis also affects the life quality of patients negatively.

Resume Objectif Dans cette etude, nous avons l’intention d’etudier les taux seriques des enzymes antioxydantes et de l’oxyde nitrique (NO) chez les femmes postmenopausees atteintes d’osteoporose (OP) ainsi que chez des temoins sains et de determiner la relation entre ces enzymes, le NO et les parametres cliniques. Methode Quarante-cinq femmes postmenopausees remplissant les criteres diagnostic de l’OP de l’Organisation mondiale de la sante (OMS) et 42 femmes saines postmenauposees sans OP ont ete incluses dans cette etude. Les patientes de l’etude ont ete selectionnees parmi des femmes non prediagnostiquees ni pretraitees pour OP. Les patientes atteintes de maladies du metabolisme osseux, presentant des antecedents de fractures osseuses, fumeuses, consommatrices d’alcool et prenant des medications antioxydantes, etaient excluent de l’etude. Les resultats de l’absorptiometrie bioenergetique a rayons X (Dexa), l’indice de masse corporelle (IMC) et les donnees demographiques furent enregistrees. L’activite des enzymes catalase erythrocytaire (Cat) et glutathion reductase (GR), ainsi que le taux erythrocytaire en glutathion (GSH), le malondialdehyde plasmatique (MDA) etaient mesures par spectrophotometrie alors que les niveaux de nitrite/nitrate (NOx) etaient mesures par lecteur de microplaques Elisa. Resultats Les patientes avaient une activite enzymatique GR significativement plus basse (p Conclusion Le stress oxydatif peut jouer un role important dans la perte osseuse postmenopausique et par consequent il devrait etre pris en compte dans l’evaluation de la pathogenese de l’OP postmenopausique.

We aimed to investigate serum antioxidant enzymes and nitric oxide (NO) levels in postmenopausal women with osteoporosis (OP) and in healthy controls; and to determine the relationship between these enzymes, NO and clinical parameters in this present study.Forty-five postmenopausal women fulfilling OP diagnostic criteria of World Health Organization (WHO) and 42 postmenopausal healthy women without OP were enrolled. Patients in the study population were selected among individuals that were not pre-diagnosed or pre-treated for OP. Patients with metabolic bone diseases, fracture history, which were smokers, alcohol users and taking antioxidant drug treatment, were excluded from the study. Dual Energy X-ray Absorptiometry (DXA) results, body mass indices and demographic data were recorded. Erythrocyte catalases (CAT), glutathione reductase (GR) enzyme activities and erythrocyte glutathione (GSH) levels, plasma malondialdehyde (MDA) levels were measured by spectrophotometer whereas plasma nitrite+nitrate (NOx) levels were measured by ELISA microplate-reader.Patients had significantly lower GR (P0.01) enzyme activity and higher levels of MDA (P0.01) and NO (P0.01) than non osteoporotic healthy controls. There was no significant difference between both groups in erythrocyte GSH levels and CAT activities. Total femoral BMD measurements significantly correlated with MDA levels (P=0.001). There was no significant relationship between other antioxidants and lumbar or femoral BMD.Oxidative stress may play an important role in postmenopausal bone loss and therefore it might be considered when pathogenesis of postmenopausal OP has been investigated.

Dropped head syndrome is primarily based on weakness localized at neck extensors. It may result from motor neuron disease, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy and also from various neuromuscular diseases including inflammatory, dystrophic and metabolic myopathies. Camptocormia (CC) on the other hand is an unusual condition characterized by progressive weakness of the extensor vertebral muscles and results in involuntary trunk flexion. CC may emerge as a clinical feature of many different conditions such as several myopathies and Parkinson's disease. The association of dropped head syndrome with CC has been rarely published in the literature. However, this is the only case presenting with concomitant dropped head syndrome and CC as a clinical picture of myotonic dystrophy (MD). In this report we aimed to represent a female patient, who was diagnosed as having myotonic dystrophy, with concurrent dropped head syndrome and CC.

Resume Le syndrome de la tete tombante est lie principalement a une faiblesse des muscles extenseurs du cou. Cette faiblesse peut etre due a une maladie du motoneurone, a une myasthenie, a une polyneuropathie demyelinisante inflammatoire chronique ou a une maladie neuromusculaire, notamment a une myopathie inflammatoire, dystrophique ou metabolique. La camptocormie est un syndrome rare secondaire a une faiblesse progressive des extenseurs du rachis, qui est responsable d’une flexion involontaire du tronc vers l’avant. La camptocormie peut s’observer dans diverses pathologies, notamment certaines myopathies et la maladie de Parkinson. L’association d’un syndrome de la tete tombante et d’une camptocormie n’a ete que rarement rapportee. Nous decrivons le premier cas dans lequel cette association a pu etre rattachee a une myotonie.