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Background: Psoriatic arthritis (PsA) is a multifaceted inflammatory disease that has a strong negative impact on the quality of life (QoL) of patients. The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire was the first disease‐specific patient‐derived instrument developed to measure the QoL in patients with PsA. Our objective was to translate the PsAQol into Arabic language and evaluate its reliability and validity in patients with PsA. Methods: This was a cross‐sectional study including patients with PsA. A clinical and biological assessment of the patients was performed at inclusion. The translation of the original PsAQoL into Arabic was performed by a professional bilingual and lay panel. Eight patients were interviewed to assess face and content validity. A separate sample of PsA patients (n = 30) were invited to participate in a test‐retest postal study in order to investigate reproducibility and construct validity. One week separated the two administrations. The Arabic version of Health Assessment Questionnaire (HAQ) was used as a comparator instrument for convergent validity. Results: Face and content validity were satisfactory. The Arabic version of the PsAQoL was found to be relevant, understandable and easy to complete in only a few minutes. One item was excluded (item 16). It had no correlation with either the other 19 items or the total score of PsAQol. The Arabic PsAQol had excellent internal consistency (Cronbach's a = 0.926), and test‐retest reliability (r = 0.982). There was a positive correlation between the total score of the PsAQoL and the Arabic version of HAQ (Spearman's r = 0.838, p < 10−3). Exploratory factor analysis had extracted two factors explaining 55% of the total variance. Conclusion: Nineteen items were selected to compose the Arabic version of PsAQoL, which was found to be relevant and understandable and has excellent reliability and construct validity. The new measure will be a valuable new tool for use in routine care for patients' assessment. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to screen the presence of silent myocardial ischaemia, in established rheumatoid arthritis (RA) patients, using a stress test then to evaluate its association with the disease activity and the cardiovascular (CV) risk factors and Heartscore. Methods: It is a transversal study in a rheumatologic centre in Tunisia. One hundred three RA patients, asymptomatic for CV diseases, were submitted to a stress test. Demographic data, CV risk factors and disease characteristics were assessed and risk factors of silent myocardial ischaemia in RA patients were identified. Results: There were 103 patients (sex‐ratio = 0.3) with a mean age of 53 ± 10 years. The evaluation of the disease activity showed that the mean Disease Activity Score in 28 joints C‐reactive protein, Clinical Disease Activity Index and Simplified Disease Activity Index were 3.9 ± 1.38, 17.17 ± 11.4 and 33.39 ± 26, respectively. The ischaemic ratio (CT/HDL) revealed that 42% of patients had a moderate to high myocardial ischaemic risk. HeartSCORE was high in 35% of cases. A silent myocardial ischaemia in the stress test was found in 11 patients (10.6%) and was associated with male sex (p = 0.03), advanced age (p = 0.04), erosive character (p = 0.05), the advanced age of the RA diagnosis (p = 0.01) and the ischaemic ratio (p = 0.05). No relationship was found with the majority of traditional CV risk factors nor with disease activity variables. Conclusion: Our results corroborated the hypothesis that the stress test could reveal subclinical CV dysfunction and supported the utility of the Heartscore as a screening tool. [ABSTRACT FROM AUTHOR]

Background: The objective of the study was to assess clinical and imaging features of rheumatoid arthritis associated with atlantoaxial dislocation (RA‐AAD) in comparison to RA without AAD (RA‐C) and to identify the associated factors to AAD. Methods: This was a retrospective comparative study including RA patients over 18 years old. The control group of RA‐C was matched according to age (±2 years), gender, and RA duration (±2 years). General data, RA characteristics, AAD features, and treatment modalities were recorded. Statistical analysis was performed to determine the predictive factors of AAD. Results: A total of 120 patients were included (78 RA‐AAD and 42 RA‐C); sex‐ratio was 0.15. Mean age was 58.55 ± 9.14 years (RA‐AAD) versus 60.43 ± 10.78 years (RA‐C), (p = 0.31). Regarding RA features, RA‐AAD patients have significantly a higher rheumatoid factor (RF) rate (p = 0.002), extra‐articular manifestations (p = 0.009) especially osteoporosis (p < 10−3), eye involvement (p = 0.02), coxitis (p < 0.0001), Disease Activity Score (DAS28) (p < 10−3), and global health status scale (HAQ) (p = 0.003). X‐ray analysis showed pathologic PADI (<14 mm) in 51.6% of cases. The AADI was pathological (>3 mm) in 100% of patients with the following distribution: 67.9% between (3–6 mm) and 23.3% between (6–9 mm). Atlantoaxial dislocation (AAD) was presumed anterior (85.4%), lateral (7.3%) and rotatory (7.3%). The abnormalities observed on magnetic resonance imaging (MRI) were: C1–C2 synovitis (61%), confirmed AAD (34.1%) and basilar impression (4.9%). AAD diagnosed by cervical MRI was anterior in 89.8% of cases, lateral (5.3%) and with a double ascending and anterior component in 4.9% of cases. An immobilisation with a type C4 cervical collar was indicated for all the patients and five of them had boluses of corticosteroid (methylprednisolone 1 g/day) for three consecutive days. C1–C2 arthrodesis by trans‐articular screwing was performed in four patients with neurological signs or pathological measurements on cervical MRI. The outcome was favourable in 100% of cases after surgical treatment with improvement in neck pain and neurological condition within a mean decline of 4 ± 3 years [1–7]. Multivariate analysis identified coxitis, osteoporosis, high baseline DAS28, and a high rate of RF positivity as predictive factors of AAD. Conclusion: Our results confirmed that predictive factors of AAD were related to higher disease activity and structural damage. These modifiable factors may be prevented by tight control, early treatment, and educating RA patients to improve treatment adherence. [ABSTRACT FROM AUTHOR]

Background: Foot function is usually assessed using self‐reported outcome measures which remain subjective in patients with rheumatoid arthritis (RA). Physical performance tests were recommended for functional assessment in lower limb osteoarthritis. However, foot function assessment's guidelines in RA are lacking. We aimed to investigate the correlation between a self‐reported outcome measure and two performance‐based physical tests for assessing foot function in RA patients. Methods: A cross‐sectional study was performed over 7 months' period including RA patients. We used Rheumatoid and Arthritis Outcome score (RAOS) as a self‐reported functional tool. Physical performance tests were 4‐min walk test (4‐MWT) and Timed up and go test (TUGT). Results: Fifty RA patients were included with 96% females and a mean age of 54.7 ± 10.4 years. Foot involvement occurred since the diagnosis of RA in 36% of patients. Foot pain was reported by 68% of patients (48% forefoot), and foot stiffness in 46% of patients. Skin lesions of the feet were found in 78% of patients, 90% had foot deformities and 56% had inflammatory disorders of feet. Radiographic lesions were found in 94% of patients. The most impaired RAOS subscales were Sports and Recreation and Quality of life. Poor physical‐based performance was found in 34% of RA patients according to 4‐MWT, in 42% of RA patients according TUGT, and in 46% of patients based on at least one performance test. RAOS was negatively correlated to the 4‐MWT and positively correlated in the subscales pain, other symptoms, activities of daily living, and Sport/Rec of the RAOS. Poor performance‐based physical tests were significantly associated with advanced age, sedentary lifestyle, higher disease activity score and impaired functional status. Foot‐related parameters significantly associated with poor performance‐based physical tests were: foot pain, foot deformity and inflammatory disorders. Multivariate analysis identified foot deformities and higher functional impairment as predictive factors for lower gait speed (4‐MWT) and older age and higher functional impairment for higher duration of TUGT. Conclusion: RAOS was significantly associated with performance‐based physical function. In the era of connected technologies, these results encourage the regular assessment of rheumatoid foot function by the RAOS score through a connected programme using wearable trackers. [ABSTRACT FROM AUTHOR]