Leith Zakraoui

Myositis ossificans circumscripta of the knee improved by alendronate

Myositis ossificans circumscripta (MOC) is a rare benign disorder characterized by heterotopic ossification of soft tissues. We report a case in a 21-year-old male who presented with knee pain after strenuous physical activity. Evidence of inflammation of the knee and a hard swelling in the subquadricipital area were the main physical findings. The initial plain radiographs showed a subpatellar soft tissue mass containing flocculent calcifications. Over the next 2 months, the calcific deposits organized into a calcified mass. Magnetic resonance imaging findings were nonspecific, with a mass within the vastus medialis muscle generating low signal on T1 images and high signal on T2 images, without postgadolinium enhancement. Computed tomography showed several calcific deposits arranged in a ring, strongly suggesting MOC. Histological examination of a biopsy specimen confirmed this diagnosis. Alendronate therapy given for 6 months was followed by marked clinical improvement, obviating the need for surgery.

Association study of TRAF1-C5 polymorphism with susceptibility to rheumatoid arthritis in Tunisian population

Joint Bone Spine - In Press.Proof corrected by the author Available online since mercredi 1 fevrier 2012

AB0187 Influence of Educational Level on The Outcomes of Rheumatoid Arthritis

Background Formal educational background has been associated with a worse health outcome and greater disease activity among patients with Rheumatoid Arthritis (RA). Objectives The aim of this study was to evaluate the influence of educational level on the outcomes of RA, in terms of disease activity and functional impairment. Methods This is a cross-sectional study, including patients with RA (1987 ACR criteria). Disease activity was evaluated by erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Disease Activity Score (DAS28) ESR. Functional disability was assessed by Health Assessment Questionnaire (HAQ). Patients were classified according to their educational level into 4 categories: illiterate, primary, secondary or university levels. Statistical analysis was done using one-way analysis of variance (ANOVA) and linear regression models. The significance level was set at p<0.05. Results A total of 67 patients with RA were evaluated, 5 men and 62 women. The mean age was 53 years [28–75] and the mean disease duration was 9.19 years [1–30]. Eighty eight percent of patients were treated with synthetic DMARDs (Disease modifying antirheumatic drugs) and 20% were treated with biologic DMARDs. With regard to the educational level, 34.3% were illiterate, 20.89% had primary level, 34.3% secondary level and 10.44% had university level There were no statistically significant differences for ESR, CRP, DAS28 and HAQ when comparing the four educational levels (p=0.176, p=0.252, p=0.528, p=0.410, respectively). However, in the multivariate analysis, after adjusting for age and biologic DMARDs, DAS28 and HAQ were significantly associated to the educational level (p=0.024, p=0.014, respectively). Conclusions This study shows that educational levels may have an influence on the disease activity and functional impairment in patients with RA. Disclosure of Interest None declared

Myosite ossifiante circonscrite du genou améliorée sous alendronate

Resume La myosite ossifiante circonscrite (MOC) est une affection benigne, rare, caracterisee par une ossification heterotopique localisee dans les tissus mous. Nous rapportons l’observation d’un jeune homme de 21 ans se plaignant progressivement, suite a une activite sportive intense, d’une douleur du genou. Cette articulation avait un aspect inflammatoire et une tumefaction blindee sous quadricipitale. Les radiographies du genou ont visualise, au debut, un epaississement des parties molles en sus-rotulien associe a des calcifications d’aspect flou. Ces dernieres se sont organisees apres 2 mois d’evolution, en une masse calcifiee plus ou moins homogene. L’aspect IRM etait non specifique avec la presence d’une masse au sein du muscle vaste interne en hyposignal T1, hypersignal heterogene T2 ne se rehaussant pas apres injection de Gadolinium. Le scanner a mis en evidence de multiples calcifications regroupees en couronne fortement evocatrices d’une MOC, confirmee par l’etude histologique d’un fragment biopsique. Le patient a ete traite par alendronate pendant 6 mois avec une nette amelioration clinique permettant ainsi de surseoir a la chirurgie.