Gout misdiagnosis due to dual-energy computed tomography artefact

Interaction between paracetamol and oral anticoagulants

Cross-cultural adaptation and validation of the French version of the Knee injury and Osteoarthritis Outcome Score (KOOS) in knee osteoarthritis patients

Udgivelsesdato: 2008-Apr OBJECTIVE: To adapt the Knee injury and Osteoarthritis Outcome Score (KOOS) into French and to evaluate the psychometric properties of this new version. METHODS: The French version of the KOOS was developed according to cross-cultural guidelines by using the "translation-back translation" method to ensure content validity. KOOS data were then obtained in patients with symptomatic knee osteoarthritis (OA). The translated questionnaire was evaluated in two knee OA population groups, one with no indication for joint replacement (medicine), and the other waiting for joint replacement (surgery). The psychometric properties evaluated were feasibility: percentage of respon…

Test-retest reliability of 3D kinematic gait variables in hip osteoarthritis patients

Import JabRef | WosArea Orthopedics; Rheumatology; International audience; Objectives: (1) to investigate the test-retest reliability of 3D gait analysis (3DGA) in hip Osteoarthritis (OA) patients; (2) to find the minimum number of gait trials needed to overcome intrinsic variability; (3) to check the accuracy of angles measured by the 3D system. Design: 23 Patients suffering from hip OA with no other major disease were recruited. We evaluated the reliability of spatio-temporal variables and body angles (lower-limb joints, trunk and pelvis angles) during two sessions of 3DGA using intra-class correlation coefficients (ICC). The minimum number of trials needed to overcome intrinsic variabili…

Le tocilizumab corrige le déséquilibre de la balance Th17/Treg chez les patients atteints de polyarthrite rhumatoïde

In response to the article published by Fukaya et al., entitled: “Relationships between the center of pressure and the movements of the ankle and knee joints during the stance phase in patients with severe medial knee osteoarthritis”

International audience

Brief Report: Inhibition of interleukin-6 function corrects Th17/Treg cell imbalance in patients with rheumatoid arthritis

OBJECTIVE: From an immunologic standpoint, the mechanisms by which treatment with tocilizumab (TCZ), a humanized anti-interleukin-6 (anti-IL-6) receptor antibody, results in improvement in rheumatoid arthritis (RA) patients are still not fully understood. In vitro studies and studies in mouse models have demonstrated the critical role of IL-6 in Th17 cell differentiation. Th17 lymphocytes have been shown to be strongly involved in RA pathogenesis, and the purpose of this study was to investigate the effect of IL-6 blockade on the balance between Th17 cells and Treg cells in patients with active RA. METHODS: Patients with active RA for whom TCZ had been prescribed by a rheumatologist were en…

Performances diagnostiques de l’IRM des sacro-iliaques et du rachis pour le diagnostic de spondyloarthrite axiale non radiographique chez des patients avec rachialgies inflammatoires chroniques

Resume Objectif Le manque de specificite des criteres IRM de l’ASAS pour la spondylarthrite axiale non radiographique (SpA ax NR) justifie d’evaluer la capacite discriminante d’autres anomalies IRM au niveau des sacro-iliaques (SI) et du rachis. Methodes Chez des patients hospitalises pour lombalgies inflammatoires, les performances diagnostiques (sensibilite, specificite, rapport de vraisemblance positif (RVP)) des anomalies IRM ont ete calculees en prenant l’avis d’experts rhumatologues comme reference : (i) sacro-iliaques : œdeme (nombre et localisation), œdeme etendu > 1 cm (deep lesion), metaplasie graisseuse (nombre), erosion (nombre et localisation), backfill ; (ii) rachis dorso-lomb…

Effects of loss of metatarsophalangeal joint mobility on gait in rheumatoid arthritis patients

Objective. To evaluate the effects of loss of range of motion (ROM) of the metatarsophalangeal (MTP) joint on the kinematic parameters of walking in rheumatoid arthritis (RA) patients. Methods. Inclusion of RA patients with inactive disease, no synovitis of the inferior limb and reduced ROM of the MTP joints. Evaluation of the ROM of the MTP dorsal and plantar flexion, and gait analysis using a three-dimensional computerized movement analysis. Calculation of gait parameters and maximal flexion and extension of the hips and knees during walking. Analysis 1 compared the ROM of dorsal and plantar flexion in patients with or without walking pain; 2 compared the gait parameters between patients …

OARSI–OMERACT definition of relevant radiological progression in hip/knee osteoarthritis

Summary Background Joint space width (JSW) evaluated in millimeters on plain X-rays is the currently optimal recognized technique to evaluate osteoarthritis (OA) structural progression. Data obtained can be presented at the group level (e.g., mean±standard deviation of the changes). Such presentation makes difficult the interpretation of the clinical relevance of the reported results. Therefore, a presentation at the individual level (e.g., % progressors) seems more attractive but requires to determining a cut-off. Several methodologies have been proposed to define cut-offs in JSW: arbitrary chosen cut-off, cut-off based on the validity to predict a relevant end-point such as the requiremen…

Vitamin D supplementation, bone turnover, and inflammation in HIV-infected patients

IF 1.307 (2017); International audience; ObjectiveTo assess whether vitamin D supplementation could be associated with a modification of inflammatory markers and bone turnover in HIV-1-infected patients.Patients and methodsPatients who participated in an initial survey in 2010 and who were followed in the same department were included in a new study in 2012. Between 2010 and 2012, vitamin D supplementation was offered to patients presenting with hypovitaminosis D as per appropriate guidelines. Clinical examinations were performed, and fasting blood samples were taken for inflammation and bone marker evaluations.ResultsOf the 263 patients who participated in the 2010 study, 198 were included…

Validation transculturelle des critères d'évaluation rapportés par le patient dans l'arthrose des membres inférieurs

In joint diseases, Patient-Reported Outcomes (PROs) are now critical outcome measures, required by health authorities and regulatory agencies. Cross-cultural adaptation and validation of the psychometric properties of such PROs are needed in order to use them in international therapeutic trials. Thanks to this complex process of cross-cultural validation, the PRO in the target language can take into account the specific socio-cultural features and the linguistic equivalences. The aim of this thesis was to undertake the cross-cultural validation of PROs specifically developed for knee and hip disorders. After explaining the published recommendations for cross-cultural adaptation and then con…

Anti-Tumour Necrosis Factor-?? Therapy for Rheumatoid and Other Inflammatory Arthropathies

Anti-tumour necrosis factor (TNF)-alpha represents a major advance in the treatment of rheumatoid arthritis (RA), ankylosing spondylitis and psoriatic arthritis. It is usually well tolerated, but a potential increase in the incidence of some infections in patients taking anti-TNFalpha agents has been reported. Compared with younger people, elderly patients have more co-morbidities and are likely to be taking more medications. Moreover, the aging process induces an increase in the rate of infections. Nevertheless, in recent studies analysing the databases of etanercept trials, the normalised incidence of adverse events, serious adverse events, medically important infections and deaths was no…

Is the pelvis-thorax coordination a valuable outcome instrument to assess patients with Hip osteoarthritis?

Objective: The evaluation of the disease severity in hip osteoarthritis (OA) patients being currently based on subjective instruments. It would be of interest to develop more objective instruments, for example based on gait analysis. The aims of this study were to explore if pelvis-thorax coordination parameters could be valuable instrument outcomes to achieve this evaluation by assessing their reliability, discriminant capacity and responsiveness. Methods: Three groups of subjects; healthy, hip OA patients with severe disease (defined as indication to surgery), hip OA patients with less severe disease (no indication to surgery) were included. Hip OA patients with severe disease were evalua…

A classification study of kinematic gait trajectories in hip osteoarthritis

The clinical evaluation of patients in hip osteoarthritis is often done using patient questionnaires. While this provides important information it is also necessary to continue developing objective measures. In this work we further investigate the studies concerning the use of 3D gait analysis to attain this goal. The gait analysis was associated with machine learning methods in order to provide a direct measure of patient control gait discrimination. The applied machine learning method was the support vector machine (SVM). Applying the SVM on all the measured kinematic trajectories, we were able to classify individual patient and control gait cycles with a mean success rate of 88%. With th…

Infections sévères à pyogènes chez les patients traités par infliximab. Étude d’une cohorte régionale

Resume Objectif. – Apprecier la prevalence des infections severes a pyogenes chez les patients traites par infliximab en pratique courante, et essayer de degager des facteurs favorisants. Methodes. – Etude portant sur une cohorte de patients traites dans un reseau regional par infliximab pour polyarthrite rhumatoide ou spondylarthrite ankylosante, et suivis de facon prospective a l’aide d’une feuille de recueil des donnees standardisee. Les observations des patients ayant presente une infection grave a pyogene ont ete analysees, et comparees a celles des autres patients. Resultats. – La cohorte comportait 83 patients (55 femmes et 28 hommes), dont cinq (6 %) ont presente une infection sever…

Validation of a Dutch diagnostic rule for gout without joint fluid analysis in patients hospitalized for acute monoarthritis

Test–retest reliability and responsiveness of centre of pressure measurements in patients with hip osteoarthritis

International audience; Objective: The aim of this study was to determine a set of measures for the evaluation of balance in patients suffering from hip osteoarthritis (OA) that were both reliable and responsive to change.Design: Three groups of subjects; Healthy, hip OA patients without surgery, and hip OA with surgery (pre and post-surgery) were included in this study. Subjects had to perform balance tests in two positions: standard and narrowed stance. CoP-based measures test-retest reliability was assessed in hip OA without surgery group, responsiveness were assessed between all groups and between pre and postsurgery.Results: Intraclass Correlation Coefficient (ICC) values from hip OA w…

Clinical effectiveness and safety of a distraction-rotation knee brace for medial knee osteoarthritis

Abstract Objective Evaluation of the clinical effectiveness and safety of a new custom-made valgus knee brace (OdrA) in medial knee osteoarthritis (OA) in terms of pain and secondary symptoms. Methods Open-label prospective study of patients with symptomatic medial knee OA with clinical evaluation at 6 and 52 weeks (W6, W52). We systematically assessed pain on a visual analog scale (VAS), Knee injury and Osteoarthritis Outcome Score (KOOS), spatio-temporal gait variables, use of nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesic-sparing effects of the brace and tolerance. Mean scores were compared at baseline, W6 and W52 and the effect size (ES) and 95% confidence intervals (95% CI…

Influence de l’expérience du lecteur sur la variabilité de mesure de l’interligne articulaire : étude transversale portant sur des lectures répétées de radiographies dans la coxarthrose

Resume Objectifs Les objectifs etaient d’evaluer l’amelioration de la mesure du pincement de l’interligne articulaire (PIA) dans la coxarthrose, en fonction de l’experience du lecteur. Methodes Cinquante radiographies de patients atteints de coxarthrose ont ete extraites de la base de donnees de l’etude randomisee et controlee ECHODIAH. Chacune d’entre elles a ete lue par deux lecteurs n’ayant pas le meme degre d’experience dans l’interpretation radiologique. Les reproductibilites intra-observateur et interobservateur ont ete evaluees par le calcul de la plus petite difference detectable (SDD) et le coefficient de correlation intraclasse (ICC). Resultats Reproductibilite interobservateur : …

Psychometric properties of the French translation of the reduced KOOS and HOOS (KOOS-PS and HOOS-PS).

Udgivelsesdato: 2009-Dec OBJECTIVE: To evaluate the psychometric properties of the French KOOS physical function (KOOS-PS) and HOOS physical function (HOOS-PS), specifically its feasibility, reliability, construct validity, and responsiveness. METHODS: Consecutive outpatients consulting for primary knee or hip osteoarthritis (OA) in a rheumatology department were included. During the initial assessment, patients were asked to complete the Knee injury and Osteoarthritis Outcome Score (KOOS) or Hip disability and Osteoarthritis Outcome Score (HOOS) questionnaire and the OsteoArthritis Knee and Hip Quality Of Life questionnaire (OAKHQOL). The patients were given a second KOOS or HOOS questionn…

Digital acrometastasis revealing endometrial cancer relapse

Prédiction de la réponse aux traitements de fond antirhumatismaux (DMARD) dans la polyarthrite rhumatoïde

Resume Objectif Examiner les facteurs potentiels predictifs de la reponse aux traitements de fond (DMARD) classiques dans la polyarthrite rhumatoide (PR). Methodes (1) design de l’etude : etude prospective sur six mois de suivi. Participants  : patients avec une PR active ; (2) intervention et suivi : introduction d’un DMARD. Reponse au traitement evaluee a six mois (criteres ACR20) ; (3) analyse : facteurs potentiels predictifs de la reponse : criteres demographiques, activite de la maladie, pourcentages de sous-populations de cellules mononucleees du sang peripherique (CMSP) exprimant la glycoproteine P, taux d’interleukine 1 beta (IL-1β) serique, IL-6, IL-8, IL-10, IL-12 et de facteur de…

Dual energy computed tomography: A breakthrough for gout?

Joint Bone Spine - In Press.Proof corrected by the author Available online since dimanche 22 decembre 2019

Th1 and Th17 lymphocytes expressing CD161 are implicated in giant cell arteritis and polymyalgia rheumatica pathogenesis.

International audience; OBJECTIVE: Giant cell arteritis (GCA) is the most frequently occurring vasculitis in elderly individuals, and its pathogenesis is not fully understood. The objective of this study was to decipher the role of the major CD4+ T cell subsets in GCA and its rheumatologic form, polymyalgia rheumatica (PMR). METHODS: A prospective study of the phenotype and the function of major CD4+ T cell subsets (Th1, Th17, and Treg cells) was performed in 34 untreated patients with GCA or PMR, in comparison with 31 healthy control subjects and with the 27 treated patients who remained after the 7 others withdrew. RESULTS: Compared with control subjects, patients with GCA and patients wi…

Machine Learning Approaches for Activity Recognition and/or Activity Prediction in Locomotion Assistive Devices—A Systematic Review

Locomotion assistive devices equipped with a microprocessor can potentially automatically adapt their behavior when the user is transitioning from one locomotion mode to another. Many developments in the field have come from machine learning driven controllers on locomotion assistive devices that recognize/predict the current locomotion mode or the upcoming one. This review synthesizes the machine learning algorithms designed to recognize or to predict a locomotion mode in order to automatically adapt the behavior of a locomotion assistive device. A systematic review was conducted on the Web of Science and MEDLINE databases (as well as in the retrieved papers) to identify articles published…

Scores échographiques : intérêt en pratique rhumatologique (exemple de la polyarthrite rhumatoïde et des spondyloarthrites)

Resume L’echographie a pris une place considerable dans la prise en charge de certains rhumatismes inflammatoires depuis dix ans, comme dans la polyarthrite rhumatoide, et commence ainsi a apparaitre dans certaines recommandations de societes savantes internationales pour le suivi de ces rhumatismes. Dans le domaine de la recherche clinique, de nombreux scores ont ete developpes pour le suivi echographique, essentiellement pour juger l’efficacite des traitements, mais peu ont pu etre transposes a la pratique clinique en raison d’une faisabilite mediocre. La plupart des scores ont concerne l’evaluation des synovites et parfois aussi celui des tenosynovites, voire des erosions dans la polyart…

Age-Related Adaptations of Lower Limb Intersegmental Coordination During Walking

Lower-limb intersegmental coordination is a complex component of human walking. Aging may result in impairments of motor control and coordination contributing to the decline in mobility inducing loss of autonomy. Investigating intersegmental coordination could therefore provide insights into age-related changes in neuromuscular control of gait. However, it is unknown whether the age-related declines in gait performance relates to intersegmental coordination. The aim of this study was to evaluate the impact of aging on the coordination of lower limb kinematics and kinetics during walking at a conformable speed. We then assessed the body kinematics and kinetics from gait analyses of 84 volunt…

L’échographie des ongles dans le rhumatisme psoriasique : étude pilote sur la faisabilité, la reproductibilité et la validité de mesure

Resume Objectif Etude de la faisabilite, de la reproductibilite et de la validite externe versus criteres de reference des parametres echographiques de l’ongle dans le rhumatisme psoriasique. Methodes Etude pilote prospective monocentrique sur huit parametres echographiques en mode B et doppler puissance portant sur l’interphalangienne distale (IPD), la matrice, le lit et la tablette ungueale. La reproductibilite intra-observateur et inter-observateur a ete evaluee pour les sept parametres quantitatifs (ICC et kappa). La recherche de correlations entre les variables echographiques et cliniques a permis d’estimer la validite externe. La faisabilite a ete appreciee par le temps d’examen et le…

Usefulness of routine hepatitis C and hepatitis B serology in the diagnosis of recent-onset arthritis. Systematic prospective screening in all patients seen by the rheumatologists of a defined area--brief report.

Ansemant, Thiphaine | Ornetti, Paul | Garrot, Jean-Francois | Pascaud, Francoise | Tavernier, Christian | Maillefert, Jean-Francis; International audience; ''Objective: Previous studies evaluating the usefulness of systematic screening for hepatitis B and C in patients with recent-onset arthritis suffered from a major bias since they were conducted in hospitals. The objective of the present study was to evaluate the relevance of such screening, performed by hospital and office-based rheumatologists of a defined area, in the diagnosis of arthritis or inflammatory polyarthralgia of less than 1 year duration. Methods: The CRRRI is a network which includes most hospital and office-based rheumat…

In response to the article published by Dewolf et al, entitled: "Effect of walking speed on the intersegmental coordination of lower-limb segments in elderly adults", GaitPosture (2019).

Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias

International audience; Background The effectiveness of intra-articular hyaluronic acid (IAHA) injection for knee osteoarthritis (KOA) is debated.Objectives To evaluate the effect of IAHA for patients with KOA by analysing data from trials of IAHA versus placebo with low risk of bias, to provide the highest level of evidence.Methods A systematic review and meta-analysis was conducted. Randomised controlled trials (RCTs) with a low risk of bias (adequate randomisation and concealment and double-blind design) that investigated IAHA versus placebo (saline solution) injection were eligible. The primary efficacy measure was pain intensity and secondary outcome function at 3 months. The treatment…

Refractory SAPHO Syndrome Involving the Mandible

Does Tocilizumab Indeed Reduce the Frequency of Th17 Cells? Comment on the Article by Thiolat et al

Cross-Talk Correction Method for Knee Kinematics in Gait Analysis Using Principal Component Analysis (PCA): A New Proposal

International audience; Background: In 3D gait analysis, the knee joint is usually described by the Eulerian way. It consists in breaking down the motion between the articulating bones of the knee into three rotations around three axes: flexion/extension, abduction/adduction and internal/external rotation. However, the definition of these axes is prone to error, such as the "cross-talk'' effect, due to difficult positioning of anatomical landmarks. This paper proposes a correction method, principal component analysis (PCA), based on an objective kinematic criterion for standardization, in order to improve knee joint kinematic analysis. Methods: The method was applied to the 3D gait data of …

Is the Short and Fast Step Test a safe and feasible tool for exploring anaerobic capacities of individuals with coronary heart disease in clinical practice?

Background While its importance in daily living, the anaerobic metabolism is not taken into account in clinical practice. The lack of validated functional performance tests for patients with chronic disabilities may explain this defect. In this context, the Short and Fast Step Test (SFST) was recently developed and validated in healthy volunteers. Aim The purpose of this study was to investigate the safety, feasibility and reliability of the SFST, a functional test exploring anaerobic metabolism in coronary patients during cardiac rehabilitation. Design This study was a monocentric prospective study. Settings This study took place in the rehabilitation center of the University Hospital Cent…

Biomechanical effectiveness of a distraction-rotation knee brace in medial knee osteoarthritis: preliminary results.

Abstract Background Non-pharmacological therapies are recommended for the care of knee osteoarthritis patients. Unloader knee braces provide an interesting functional approach, which aims to modulate mechanical stress on the symptomatic joint compartment. We aimed to confirm the biomechanical effects and evaluate functional benefits of a new knee brace that combines a valgus effect with knee and tibial external rotation during gait in medial osteoarthritis patients. Methods Twenty patients with unilateral symptomatic medial knee osteoarthritis were included and they performed two test sessions of 3D gait analysis with and without the brace at the initial evaluation (W0) and after 5weeks (W5…

Intérêt du dépistage systématique des hépatites B et C à visée diagnostique dans le bilan initial des rhumatismes inflammatoires débutants

Resume Objectif Les etudes realisees a ce jour pour evaluer l’interet d’un depistage systematique de l’hepatite B et C en cas d’arthrite d’installation recente souffrent toutes d’un biais methodologique important lie au recrutement hospitalier des malades. L’objectif de la presente etude consistait a evaluer la pertinence d’un tel depistage realise par les rhumatologues hospitaliers et liberaux d’une region geographique predefinie pour le diagnostic etiologique des arthrites et polyarthralgies inflammatoires datant de moins d’un an. Methodes Le CRRRI est un reseau qui rassemble la plupart des rhumatologues hospitaliers et liberaux d’une region de 506 755 habitants. Nous avons inclus tous le…

Burned to the Bone

A burn-related injury that had worsened over time was compatible upon radioclinical examination with severe psoriatic arthritis (PsA), but was missing several essential characteristics of that disorder. A 58-year-old woman with no personal or family history of rheumatic diseases consulted for hand arthralgia. Her medical history was marked by severe burns to 80% of her body, sparing the face and the back, following a gas explosion 20 years earlier. …

Reliability, validity and feasibility of nail ultrasonography in psoriatic arthritis

International audience; Objective: To determine the feasibility, reliability and validity of nails ultrasonography in psoriatic arthritis as an outcome measure.Methods: Pilot prospective single-centre study of eight ultrasonography parameters in B mode and power Doppler concerning the distal interphalangeal (DIP) joint, the matrix, the bed and nail plate. Intraobserver and inter-observer reliability was evaluated for the seven quantitative parameters (ICC and kappa). Correlations between ultrasonography and clinical variables were searched to assess external validity. Feasibility was assessed by the time to carry out the examination and the percentage of missing data.Results: Twenty-seven p…

Milwaukee shoulder syndrome affecting the elbow.

Spondylarthropathie tardive ressemblant à des métastases ostéoblastiques multiples

Osteitis fibrosa cystica

Joint Bone Spine - In Press.Proof corrected by the author Available online since vendredi 27 mai 2016

Prediction of response to disease modifying antirheumatic drugs in rheumatoid arthritis.

Abstract Aim To investigate potential predictors of response to conventional DMARDs in RA. Methods Study design – 6-month follow-up prospective study. Participants RA patients with active disease. Intervention and follow-up Introduction of one DMARD. Response to treatment evaluated at 6 months (ACR20 criteria). Analysis Potential predictors of response, patients’ demographics, disease activity, percentages of PBMC subsets expressing P-gp, serum IL-1β, IL-6, IL-8, IL-10, IL-12, TNF-α levels, were evaluated using univariate and multivariate logistic regression analysis. ROC curve analyses were performed in order to obtain thresholds allowing the prediction of response. Results Forty-two patie…

Pneumopathies non infectieuses induites par les biothérapies ciblées

Resume Les biotherapies des rhumatismes inflammatoires chroniques ont revolutionne leur prise en charge. Ces nouveaux medicaments sont susceptibles d’induire des effets secondaires multiples, parfois severes et ceux-ci peuvent atteindre l’appareil respiratoire. Les presentations cliniques et radiologiques sont multiples et l’apparition de symptomes respiratoires chez un patient sous biotherapie doit faire suspecter un effet iatrogenique avec au premier plan la survenue de pneumopathies interstitielles diffuses parfois tres severes, de granumolatoses et d’anomalies auto-immunes. La complication infectieuse doit toujours etre eliminee. La demarche est complexe et doit etre rigoureuse ce d’aut…

Le scanner double énergie : une vraie avancée dans la goutte ?

Severe hypovitaminosis D correlates with increased inflammatory markers in HIV infected patients

Abstract Background Even though it has been suggested that antiretroviral therapy has an impact on severe hypovitaminosis D (SHD) in HIV infected patients, it could be speculated that the different levels of residual inflammation on HAART (Highly Active Anti Retroviral Therapy) could contribute to SHD and aggravate bone catabolism in these patients. Methods A cross-sectional study was carried out in an unselected cohort of 263 HIV infected outpatients consulting during Spring 2010. Clinical examinations were performed and medical history, food habits, sun exposure and addictions were collected. Fasting blood samples were taken for immunological, virological, inflammation, endocrine and bone…