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Background. We aimed to evaluate the severity of lower urinary tract symptoms (LUTS) in rheumatoid arthritis (RA) and spondyloarthritis (SpA) male patient versus control, then to determine the relation of LUTS with rheumatic diseases (RD) characteristics and with erectile dysfunction (ED). Methods. We conducted a cross-sectional case control study including 50 men with RA or SpA and 50 healthy controls. LUTS were evaluated by the International Prostate Symptom Score (IPSS). LUTS bother was evaluated by the Quality of life (QoL) score, which ranges from 0 to 6. LUTS bother was considered if QoL score exceeded 2. Moreover, erectile function was assessed by the International Index of Erectile Function-5 (IIEF5) (ED if score < 21). Results. LUTS were significantly more severe in RD patients than controls (p = 0.03). However, there was no difference between the two groups in LUTS bother (QoL) (p = 0.2). Comparing RA and SpA showed no difference as to the severity of LUTS or effect of bother on QoL (p = 0.13, p = 0.5). The prevalence of ED in RD patients was not significantly higher than controls (80% versus 70%; p = 0.2).There were also no differences either between RA and SpA groups (p = 0.74). The severity of LUTS for patients with RD (RA and SpA) was significantly associated with age (p = 0.001), age at disease onset (p = 0.002) and ED (p = 0.008). Conclusion. According to our study, men with RD seem to be exposed to more severe LUTS than controls. Also, the severity of LUTS was associated with ED, age of patients and the age of disease onset.

Background Acroosteolysis refers to a destructive process involving the distal phalanges of the fingers and toes that may extend to metacarpals or metatarsals. Rarely idiopathic, the diagnosis of primary acroosteolysis requires ruling out other causes. Juvenile idiopathic arthritis is an exceptional aetiology of acroosteolysis occurring mainly in psoriatic arthritis. Here by a case of juvenile idiopathic arthritis associated with acroosteolysis of the toes. Methods A 13-year-old girl with no past medical history, presented to our department of rheumatology with oligoarthritis affecting both wrists and knees. She had no familiar history of psoriasis nor rheumatic diseases. She described a dull ache and recurring swelling of knees evolving for >6 years associated with a macular rash of the chest without fever. On examination, the knees were swollen with a limited range of motion of Results Plain radiograph of the feet revealed bone resorption of the second and fifth distal phalanges without signs of reconstruction. Other secondary causes of acroosteolysis were ruled out. The diagnosis of oligoarticular juvenile idiopathic arthritis was made. In view of the involvement of the distal phalanges, the phenotype of psoriatic arthritis was probable. The patient was initially treated with non-steroidal anti-inflammatory drugs as well as intraarticular injections of corticosteroids in knees. As the flares persisted, she was put on Methotrexate at a dosage of 15 mg per week with marked clinical improvement. Conclusion Our case illustrates a possible occurrence of acroosteolysis of the feet in the field of an active juvenile idiopathic arthritis. It is important to rule out other causes and make a rapid diagnosis in order to ensure appropriate management decisions.

Background Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory rheumatic disease of childhood that can cause major physical disability, impairing patients' ability to lead a normal adult life. The objective of this study was to assess the outcomes of oligo- and polyarticular JIA in adulthood as well as the progression to authentic rheumatoid arthritis (RA). Methods We conducted a retrospective study including adult patients with JIA (diagnosed according to the International League of Associations for Rheumatology [ILAR]). Data collected included age, gender, disease characteristics (JIA subtype, disease duration). The progression to an authentic RA was determined by checking the response to the ACR/EULAR 2010 classification criteria. Results Twenty-eight patients were included in this study. There was a female predominance with a sex ratio of 1.5. The mean age of disease onset was 6 years and 2 months [2–17]. The mean age at inclusion was 29.5 years [18–64]. The frequency of each JIA subtype was as follows: polyarticular with RF + (n = 14), polyarticular with RF- (n = 9), oligoarthritis (n = 5). The polyarticular forms: RF+ and RF- evolved into genuine seropositive and seronegative RA in 71.4% and 66.7% of cases, respectively. Among the oligoarticular JIA subtype, an extension of the disease to a seronegative RA was noted in one patient (20%). Hip involvement was noted in 20% of patients. Carpal tunnel syndrome and elbow arthritis were found in 28.5% and 14.3% of patients, respectively. Regarding treatment modalities and at the time of recruitment, 36.3% of RAs were treated with Methotrexate, and 33% were on biological treatment. Ten percent of the patients dropped out of school because of disease flares and deformities. Conclusion Our study showed oligo- and polyarticular JIA evolves in most of the cases towards an authentic RA causing deformities and handicaps. Earlier management is necessary to allow a better transition to adulthood.

Background:Studies have shown that the association of pain, stiffness, disability, and social restrictions in rheumatoid arthritis (RA) patients induce a significantly increased level of depressed mood and stress. The use of favorable coping strategies could lead to improve physical and psychological well-being.Objectives:To evaluate coping strategies of RA patients and their associations with health-related quality of life (HRQoL) outcomes.Methods:A cross-sectional sample of patients with established RA was evaluated using measures of coping: the Brief-COPE (scores presented for the two overarching coping styles: Approach coping including active coping, emotional support, use of informational support, positive reframing, planning and acceptance, and Avoidant coping including self-distraction, denial, substance use, behavioral disengagement, venting and self-blame), the HRQoL (Mental and Physical Components [MCS/PCS] of the Short Form 12), and the Rheumatoid Arthritis Impact of Disease score (RAID]. Multiple linear regression analyses were performed to evaluate the associations between coping strategies and HRQoL outcomes.Results:The study sample comprised 45 patients with a female predominance (91.9 %), and a mean age of 55.7± 9.9 years [38-77]. The median disease duration was 10 years [38-77]. The majority of patients (82.8 %) were positive for either rheumatoid factor or anti-CCP. Half of the patients were on biological disease-modifying antirheumatic drugs. Two active coping strategies were identified: Approach coping (E = 4.29) and Avoidant Coping (E=3.86), which explained 40% of the total variance. Mean RAID was 4.8± 1.6, while the mean PCS and MCS were 31.9 ± 9.4 and 39.7 ± 9.4, respectively. Approach coping and avoidant coping were associated with PCS (r= 0.4, p = 0.03), (r=0.3, p=0.008) respectively. However, no association was found between coping strategies and MCS or RAID (p>0.05). In the multivariate model, approach coping and avoidant coping were significant to explain lower disease-specific HRQoL (PCS) (Beta= 0.4, p= 0.008), (Beta=0.3, p=0.02) respectively.Conclusion:Approach and avoidance are associated with lower disease-specific HRQoL (PCS) but not with lower disease-specific HRQoL (MCS). Doctors should not forget to help their patients developing adaptive coping strategies.Disclosure of Interests:None declared

Bisphosphonates-induced avascular osteonecrosis of the jaw is rarely reported after osteoporosis’ treatment. We report a case of Jaw avascular osteonecrosis associated with a residronate oral treatment for post menopausal osteoporosis in a 49-year-old woman. She presented with jaw pain, difficulty in masticating following teeth avulsions. The clinical appearance simulated dental abscesses. The radiological exam showed a large osteolysis of the left posterior region of right mandible. The diagnosis of avascular necrosis of the jaw was retained. She was treated by ablation of bone sequestrum associated to an antibiotic treatment associated with hyperbaric oxygen treatment. Currently, the recommended treatment for this osteonecrosis is essentially symptomatic and conservative. The preventive treatment consists on a complete dental evaluation performed before starting bisphosphonate treatment

We report a 21-year-old female patient known to have Juvenile idiopathic arthritis (JIA) who later developed multiple sclerosis (MS). The disease was documented on the brain and cerebral magnetic resonance imaging (MRI) and the visual evoked potential. Our case emphasizes the need to evaluate the symptoms and brain MRI carefully. The concurrence of MS and JIA is uncommon. The possible relationship between the 2 diseases was discussed.