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La enfermedad ósea de Paget (EP) es un trastorno focal, asintomática en la mayoría de los casos y de naturaleza desconocida. La epidemiología de esta enfermedad está poco caracterizada; se desconoce su prevalencia e incidencia globales en España. El objetivo del estudio es determinar la prevalencia y la incidencia de la EP en un área de la ciudad de Barcelona (Barceloneta) que posee un sistema de atención sanitaria en el que la asistencia primaria, hospitalaria y especializada están integradas y en el que se disponen de archivos informatizados de exploraciones complementarias, diagnósticos y tratamientos. Pacientes y métodos: La población del área de la Barceloneta es de 18.509 habitantes (Censo de 1996) con 6.989 personas mayores de 55 años. Se procedió a la identificación de los pacientes afectos de EP residentes en el área de la Barceloneta, tras la revisión de archivos informatizados de diagnósticos, tratamientos, analíticos, anatomía patológica, radiología y gammagrafías óseas del centro de asistencia primaria (CAP), del servicio de Reumatología y de otros servicios del Hospital del Mar. En los casos detectados se comprobó el diagnóstico mediante la revisión de la historia clínica por parte de dos investigadores. Resultados: Se detectaron 16 pacientes (10 mujeres y 6 hombres). Edad media 79.2 años (intervalo: 65-92). Monostóticos/Poliostóticos: 8/8. Sintomáticos/Asintomáticos: 9/7. La prevalencia aparente en la población mayor de 55 años fue de 0.23%. En el periodo 1996-2000 se diagnosticaron cinco casos nuevos, siendo la incidencia de 1.78/10.000 personas/año. Asumiendo que sólo el 20% de los casos son sintomáticos, se puede inferir que el número total de pacientes es de 45, siendo la P real calculada de 0.64%. Conclusiones: En el área de la Barceloneta (Barcelona, España), la prevalencia real calculada es de 0.64% y la incidencia estimada de 1.78/10.000/personas-año, cifras todas ellas referidas a población mayor de 55 años.

Objectives: To determine if there is a clinicodemographic or serological profile associated with MRI-confirmed inflammatory musculoskeletal abnormalities in SLE patients. To investigate the relationship between these alterations and HRQoL., Methods: patients with SLE from our previous study in whom a wrist and hand MRI with contrast was performed were included. Sociodemographic, clinical, therapeutic, serological data and PROs were collected and correlated with MRI findings., Results: 83 patients were analysed. Erosions and synovitis were more common in older patients (55 ± 12.61 vs 45.06 ± 12.18 years, p .001, 52.78 ± 12.99 vs 44.95 ± 12.49 years, p .011). Synovitis was less frequent in patients with nephritis (6.7% vs 24.3%, p .031). Treatment received showed some associations: patients with bone edema received more methotrexate (25% vs 6.3%, p .033), those with erosions and peritendonitis received less mycophenolic acid (5.6% vs 22.9%, p .034; 0% vs 12.8%, p .026). Peritendonitis correlated with higher SLEDAI-2K (7 ± 2.45 vs 3.64 ± 3.34, p .018)., Worse Haq: Patients with synovitis, tenosynovitis, peritendonitis and bone edema reported higher pain (6.03 ± 2.57 vs 4.26 ± 2.49, p .005; 6.56 ± 1.95 vs 4.76 ± 2.75, p .017; 8.80 ± 1.30 vs 4.95 ± 2.55, p .001; 6.47 ± 2.62 vs 4.83 ± 2.58, p .026, respectively). Patients with synovitis reported higher fatigue numerical values (2.32 ± 0.82 vs 1.91 ± 0.84, p .035), with tenosynovitis worse FSS-9 (61.50 ± 1.73 vs 45.70 ± 16.80, p .015), and with both synovitis and peritendonitis worse HAQ (1.14 ± 0.69 vs 0.75 ± 0.65, p .031; 1.69 ± 0.07 vs 0.90 ± 0.69, p .018)., Conclusion: SLE patients with confirmed musculoskeletal alterations on MRI were generally older, less likely to have lupus nephritis, and received different treatments. They reported a worse HRQoL in terms of pain, fatigue and functional disability., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Thromboembolic events tend to arise during the natural lifetime of tumors. However, multiple thromboemboli mimicking catastrophic antiphospholipid syndrome is quite rare as a first manifestation of a tumor. Herein we describe the case of a 51-year old woman that presented with multiple thromboemboli affecting her brain, lung and kidneys. Despite bolus administration of corticosteroids, anticoagulant therapy and immunoglobulin infusion treatment, the patient died. She had suffered from two occult tumors, which could not be identified premortem: a lung adenocarcinoma and an intrahepatic cholangiocarcinoma. This case underscores the importance of determining the underlying etiology behind multiple thromboemboli. The most important prognostic factor is rapid initiation of treatment of the multiple thromboemboli, emphasizing treatment of their etiology., (Copyright © 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.)