F. Allali

Behçet's disease in Moroccan children: a report of 12 cases

We report 12 cases of Behçets disease (BD) in children. The mean age of symptom onset was 12.4 years. Four patients (33.3%) had a past familial history of BD. Clinical manifestations were: oral aphtosis (n=12), genital aphtosis (n=9), ocular involvement (n=9), neuro‐Behçet (n=6), venous thrombosis (n=4), articular involvement (n=3), and entero‐Behçet (n=1). All patients but one were initially treated with steroids; three cases with ocular involvement were treated with chlorambucil; and three other cases of neuro‐Behçet were treated with cyclophosphamide. After a mean follow‐up of 4 years, four patients with neurological involvement developed steroid‐dependence with recurrence of symptoms. Four patients had optic atrophy with blindness.

Prevalence and clinical characteristics of tuberculosis in rheumatoid arthritis patients

Patients with rheumatoid arthritis (RA) have been shown to have an increased susceptibility to the development of infections [1, 2]. The exact causes of this increased risk are unknown, but may be related to immunologic disturbances associated with the disease or to the immunosuppressive effects of agents used in its treatment [3, 4]. Recently, the question of whether patients with RA are at increased risk of developing tuberculosis compared with the general population has gained interest in light of reports of serious cases in patients receiving biologic therapies for the disease [5, 6]. Mycobacterium infection is an important cause of morbidity and mortality in patients with RA, especially in prevalent areas [7, 8]. Tuberculosis infection in RA has been reported with an incidence rate of 2.3/1000 patient years, which is higher than in the general population [7]. According to a national study, the prevalence of active tuberculosis in Morocco is estimated to be 160–180/100,000 patients. The aim of this report was to assess the prevalence and the clinical features of tuberculosis infection in RA patients living in Morocco.

A case of post-pregnancy osteoporosis-related spinal fractures in association with ankylosing spondylitis

Osteoporosis in pregnancy is a rare clinical problem of unknown cause [1, 2]. Some authors believe that even pregnancy is associated with a general reduction in bone density. This would not be of sufficient magnitude to cause fractures unless the woman already had a substantial decrease in bone mass [3]. We report a case of post-pregnancy spinal fractures in association with ankylosing spondylitis (AS) induced by osteoporosis.

AB0365 Sleep Disorders in Moroccan Patients with Rheumatoid Arthritis

Objectives This study aimed to evaluate the frequency of sleep disorders in patients with rheumatoid arthritis (RA) and to explore the determinants of these disorders. Methods It is a cross-sectional study including patients with RA. Patients with a known psychiatric disorder were excluded from the study. The demographic characteristics of patients and the characteristics of RA were collected. Pain and fatigue were assessed by a visual analogue scale (0-100 mm), the disease activity by DAS28 - ESR (Disease Activity Score), the Functional Disability by the Arabic validated version of the Health Assessment Questionnaire (HAQ), the quality of life by Euroqol 5D and psychological state by the Arabic validated version of the questionnaire Hospital Anxiety and Depression (HAD) with its two items anxiety and depression. Participants completed the self-rated questionnaire “Pittsburgh Sleep Quality Index (PSQI)” that assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven “component” scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The total score ranges from 0 (no disorder) and 21 (major problems) 1. Univariate and multivariate linear regression was performed to determine factors associated with poor sleep quality. Results 103 patients were included with a mean age of 49.7±11.4 years and a female predominance (90 (87.4%)). The median of RA duration was 8.16 years [3.25 to 14.16]. The median of global score PSQI was 5 [2-9]. Poorer Sleep quality was significantly associated with high disease activity (r =0.381, 95% CI [0.465, 1.320], p<0.001), lower quality of life (r = -0.327, 95% CI [-5.396 - 1.474], p=0.001), greater functional disability (r =0.289, 95% CI [ 0.323, 1.539], p=0.003), greater pain severity VAS (r =0.350, 95% CI [0.023, 0.075], p<0.001), increased fatigue VAS (r =0.380, 95% CI [0.030, 0.084], p<0.001), higher levels of anxiety (r =0.385, 95% CI [0.178, 0.498], p<0.001) and depression (r =0.310, 95% CI [0.103, 0.417]. In multivariate analysis, sleep disorders were associated with only higher levels of anxiety (r =0.254, 95% CI [0.033, 0.413], p=0.022). Conclusions Our study suggests that sleep disorders, in rheumatoid arthritis, are more frequently found in patients with associated anxiety disorders. References Sleep Quality and Functional Disability in Patients with Rheumatoid Arthritis; FS Luyster, ER Chasens, MCM Wasko et al; Journal of Clinical Sleep Medicine, Vol. 7, No. 1, 2011 Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4772

Uvéite bilatérale au cours d’une polychondrite atrophiante: À propos d’une observation

We report a rare ocular manifestation of relapsing polychondritis. A 28-year-old woman presented with a 5-year history of relapsing polychondritis with chondritis of the nose, ears and tracheobronchial system. The ocular symptoms were bilateral uveitis with macular involvement and papillaedema. Ocular manifestations of relapsing polychondritis occur in 60% of patients. Uveitis is a rare symptom, sometimes severe, which can lead to blindness. This case report with a literature review sheds light on the features of this disease.

Hip dislocation revealing hip tuberculosis. A case report

Hip dislocation is an uncommon presentation of hip tuberculosis. We report a case in an 18-year-old woman with active hip tuberculosis. An attempt to reduce the dislocation 7 weeks into antituberculous therapy was followed by necrosis of the femoral head. Although severe forms of hip tuberculosis are common in endemic areas, dislocation is exceedingly rare. Capsule laxity and/or synovial hypertrophy probably contribute more to the occurrence of dislocation than does the accumulation of pus.

AB0885 Prevalence of ultrasonographic gout specific signs of foot joints

Objectives To evaluate the prevalence of ultrasonographic gout specific signs of foot joints. Methods This is a cross-sectional study which includes 15 patients with chronic gout, defined according to the American College of Rheumatology criteria (ACR 1977). Ultrasound (US) examination was performed using a high-frequency linear probe (Toshiba Xario®, frequency (8–14 MHz)) in B mode. 330 articular sites were studied at their dorsal surface. The ultrasound has objectified the presence of two signs: hyperechoic band over the superficial margin of the articular cartilage described as a double contour (DC) and tophaceous deposits at the joint cavity. Results The mean age at onset was 54.7±12,6 years, and the median diagnosis duration was 0 (0.3) years). The results of the US examination are summarized in Table 1.Table 1. Prevalence of ultrasonographic gout specific signs of hind-foot, mid-foot and Metatarso-phalangeal joints in the studied population Joints (N=330) Double contour (%) Tophaceous deposits (%) Hind-foot 8,8 10 Talocrural (N=30) 13,3 13,3 Subtalar: Lateral (N=30) 3,3 10 Medial (N=30) 10 6,7 Mid-foot 14,4 32,2 Talonavicular (N=30) 13,3 13,3 Intertarsal (N=30) 6,7 43,3 Tarsometatarsal (N=30) 23,3 40 MTP (N=150) 11,3 18 MTP 1 (N=30) 33,3 56,7 MTP 2 (N=30) 13,3 13,3 MTP 3 (N=30) 6,7 3,3 MTP 4 (N=30) 0 6,7 MTP 5 (N=30) 3,3 10 Conclusions This study showed a predilection for the gout specific ultrasound signs (DC and tophaceous deposits) in the tarsometatarsal and metatarsophalangeal joints, especially in the first MTP. The contribution of musculoskeletal ultrasound seems to be very interesting to objectify the presence of gout specific signs of the foot joints. Disclosure of Interest None declared

AB0862 The sensitivity of the double contour sign in hand joints would be better by the dorsal surface examination

Objectives To compare the prevalence of ultrasonographic gout specific sign double contour between the dorsal and palmar surfaces of the hand joints. Methods This is a cross-sectional study which includes 15 patients with chronic gout, defined according to the American College of Rheumatology criteria (ACR 1977). Ultrasound (US) examination was performed using a high-frequency linear probe (Toshiba Xario®, frequency (8–14 MHz)) in B and Doppler modes. 560 articular sites were studied at their dorsal and palmar surfaces. We compared the prevalence of the hyperechoic band over the superficial margin of the articular cartilage described as a double contour (DC) between the dorsal and palmar surfaces at each site studied. Results The mean age at onset was 54.7±12,6 years, and the median diagnosis duration was 0 (0.3) years). The results of the US examination are summarized in Table 1 Table 1. comparison of double contour prevalence between the dorsal and palmar surfaces of wrist, MCP, PIP and DIP joints in the studied population Joints (N=540) Dorsal surface (%) Palmar surface (%) P Wrist joints (N=120) 12,6 7,3 <0.001 Radiocarpal (N=30) 20 6,7 0,6 Ulnocarpal (N=30) 13,3 6,7 0,01 Scaphotrapezial (N=30) 3,3 13,3 0,8 Trapeziometacarpal (N=30) 13,3 3,3 0,1 MCP (N=150) 8 6,6 <0.001 MCP 1 (N=30) 3,3 10 0,1 MCP 2 (N=30) 13,3 6,7 0,014 MCP 3 (N=30) 6,7 6,7 0,002 MCP 4 (N=30) 6,7 0 <0.001 MCP 5 (N=30) 10 10 <0.001 PIP (N=150) 4 7,3 <0.001 IP (N=30) 3,3 10 0,1 PIP 2 (N=30) 6,7 3,3 0,9 PIP 3 (N=30) 6,7 13,3 0,01 PIP 4 (N=30) 3,3 10 0,1 PIP 5 (N=30) 0 0 <0.001 DIP (N=120) 0,8 3,3 0,033 DIP 2 (N=30) 0 0 <0.001 DIP 3 (N=30) 3,3 3,3 0,002 DIP 4 (N=30) 0 3,3 <0.001 DIP 5 (N=30) 0 6,7 <0.001 Conclusions Our study suggests that globally, DC predilect significatily in dorsal than in palmar surfaces of hand joints. These results should be verified on a larger population. Disclosure of Interest None declared

AB0859 Is There a Relationship Between Sarcopenia, Obesity and Radiographic Severity of Knee Osteoarthritis?

Objectives The purpose of this study was to analyze the association between the radiographic severity of knee osteoarthritis (OA) and 4 different categories of body composition: normal, sarcopenic nonobesity, nonsarcopenic obesity, and sarcopenic obesity Methods This was a cross-sectional study using the data from 73 participants with primary knee osteoarthritis ACR criteria. Information on demographics, comorbidities and medication was gathered. Anthropometrical measurements included weight, height and waist circumference. Radiographic knee OA was performed in all patients (based on the classification of kellgren- lawrence). Appendicular skeletal muscle mass (ASM) and whole-body fat mass were measured using dual x-ray absorptiometry. Sarcopenia was defined as a skeletal muscle mass index =ASM/height2 <1.55kg/m2 in women and <7.26 kg/m2 in men according to Baumgartner anthropometric equation. Results 73 patients were included with a mean age of 61.87±3.93 years with a female predominance (95.9%), the median disease duration was 48 month [21-78].The prevalence of each body composition category was as follows: 38.4% normal, 35.4% nonsarcopenic obesity, 4.1% sarcopenic nonobesity, and 4.2% sarcopenic obesity. In univariate analysis, compared with nonsarcopenic obesity participants, participants with sarcopenic obesity were significantly older, had lower ASM, higher whole-body fat mass, and higher waist circumference. However, there was no significant difference in body weight or BMI. In multivariate analysis, sarcopenic obesity was more closely associated with radiographic severity of knee OA than was nonsarcopenic obesity. Sarcopenic nonobesity showed no significant association with knee OA. Conclusions Sarcopenic obesity was more closely associated with radiographic severity of knee OA than was nonsarcopenic obesity, although both groups had equivalent body weight. This finding supports the importance of the systemic metabolic effect of obesity in knee OA Disclosure of Interest None declared

AB0903 Is There Any Relationship between the Children Health Assessment Questionnaire (CHAQ) and the European Quality of Life (EUROQOL) in Children Suffering from Chronic Haemophilic Arthropathy?: Table 1

Objectives We aimed to analyze in children suffering from chronic haemophilic arthropathy relation between there functional impact and there quality of life. Methods Twenty- three children (mean age of 10.9±3.5 years [4-18]) suffering from severe haemophilia (median disease duration of 12 months (6; 18),median diagnosis delay of 0 months (0, 7)) were included. Functional impairment and quality of life were respectively assessed by the Moroccan versions of Children Health Assessment Questionnaire (CHAQ) and the European Quality of Life (the EUROQOL). A statistical analysis was conducted to determine the correlation between these two parameters using the r of Spearman Results Chronic haemophilic arthropathy affected knee, elbow, ankle and wrist in respectively 50, 27.5, 20 and 2.5%. Median CHAQ was 0.37 (0, 1.25). EUROQOL domains were affected as following: Mobility (69.6%),usual activity (65.2%), self-care (65.2%), anxiety/depression (43.4%) and pain (34.7%) Table 1 summarize correlation between the CHAQ and the 5 domains of EUROQOL. Table 1 Domains of EUROQOL CHAQ P r Mobility 0.04 0.432 Self care 0.004 0.579 Usual activity 0.01 0.484 pain 0.2 0.147 Anxiety/depression 0.7 0.146 Conclusions This study suggests that the functional impact of chronic haemophilic arthropathy in children affected by severe hemophilia seems mainly related to the domains of mobility, self-care and usual activity of the EUROQOL. Further studies are required to verify those results. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4867