H Rkain

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.

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

AB0752 Ultrasound features of shoulder involvement in patients with ankylosing spondylitis: a case-control study

Objectives to investigate the prevalence of ultrasound (US) abnormalities in shoulders of patients with ankylosing spondylitis (AS), and to determine predictive factors of ultrasound shoulder enthesitis. Methods 38 AS patients were included with 38 age and sex-matched healthy controls. All patients fulfilled the modified New York criteria for ankylosing spondylitis. Clinical and demographical data were recorded. US examination of bilateral shoulders was performed by a musculoskeletal sonographer according to a defined protocol that included imaging of the insertions of supraspinatus, subscapularis and infraspinatus tendons, rotator cuff tendons, subacromial-subdeltoid bursa, acromioclavicular joint, and glenohumeral joint. Results the mean age of patients and controls was 36 years, each group of patients and controls comprised 22 men (57.9%) and 16 women (42.1%). Disease duration was 9.6±7.2 years. Among 38 AS patients, 21 had coxitis (55%) and 19 had previous or current shoulder pain (50%). AS shoulders presented significantly more ultrasound enthesitis than controls shoulders (43 shoulders (56.6%) versus 8 shoulders (10.5%) respectively). Involvement of rotator cuff tendons was significantly higher in AS patients compared with control subjects (16/38 (42.1%) versus 6 (15.2%) respectively). However, involvement of glenohumeral and acromioclavicular joints was infrequent in both groups. In AS patients, we found that the presence of coxitis was the only significant predictive factors of shoulder enthesitis (Odds Ratio (OR) =9.4; Confidence interval (CI)95% (1.10; 81.9), p=0.04) Conclusions Ultrasound abnormalities of shoulders are common in patients with ankylosing spondylitis, and the most frequent abnormality was enthesitis, which was associated with the presence of coxitis. Disclosure of Interest None Declared