Contexte et objectif. L’enjeu majeur dans le management de l’ostéoporose est l’identification des sujets à risque par la quantification du risque fracturaire. L’objectif de l’étude était d’évaluer le risque fracturaire chez les patients ayant consulté pour douleur du squelette axial. Méthodes. Il s’agissait d’une série des cas multicentriques menée sur des patients recrutés dans 8 hôpitaux de Kinshasa. Les paramètres d’intérêt comme l’âge, le sexe, l’alcoolisme, le tabagisme, la fracture de hanche chez un parent de 1er degré ou une fracture personnelle de fragilité ont été collectés auprès de chaque patient. La mesure de la densité osseuse avait été réalisée par absorptiométrie biphotonique à rayons X. Le risqué fracturaire a été évalué par le calcul de l’indice fracturaire FRAX. Ce risque était élevé lorsque la probabilité de survenue de fracture de hanche était ≥ 3% et/ou des fractures ostéoporotiques majeures ≥ 20%. Des tests statistiques usuels ont été utilisés pour l’analyse des résultats. Résultats. 90 patients dont 75 femmes étaient inclus. Leur âge moyen était de 63,5±12 ans. L’ostéoporose était diagnostiquée chez 34,4% des patients, l’ostéopénie chez 43,9% et 16,7% avaient une densité minérale osseuse normale. Aucune fracture ostéoporotique n’a été observée dans la présente étude, mais près de 30% de l’ensemble de l’échantillon avaient un risque fracturaire élevé. L’ostéoporose était associée, dans environ 80% des cas (p<0,005), à un risqué fracturaire élevé. Conclusion. La présente étude a montré que le risque fracturaire était élevé chez les patients atteints d’ostéoporose. Elle met en lumière la nécessité d’un dépistage précoce de cette pathologie. English title: Osteoporosis and assessment of fracturary risk using the frax tool in Congolese patients with axial rheumatism: A multicenter case series Context and objective. The major challenge in the management of osteoporosis is the identification of subjects at risk by quantifying the fracture risk in order to prevent the fracture cascade. The aim of the present study was to evaluate the fracture risk in patients who had consulted for axial skeletal pain. Methods. This was a multicenter case series carried out on patients with axial rheumatism recruited in 8 hospitals in Kinshasa. The parameters of interest such as age, sex, alcoholism, smoking, hip fracture in a 1st degree relative or personal fragility fracture were collected from each patient. Bone mineral density was measured by dual energy x-ray absorptiometry. Fracture risk was assessed by calculating the FRAX fracture index. This risk was considered high when the probability of occurrence of a hip fracture was ≥ 3% and/or major osteoporotic fractures ≥ 20%. Standard statistical tests were used to analyze the results. Results. 90 patients including 75 women (83.3%) were involved. Their average age was 63.5±12 years. Osteoporosis was diagnosed in 34.4% of patients, osteopenia in 43.9% of patients and 16.7% of patients had normal bone mineral density. No osteoporotic fractures were observed, but nearly 30% of the entire sample had a high fracture risk. Osteoporosis (T-score ≤-2.5) was associated, in approximately 80% of cases (p<0.005), with a high fracture risk. Conclusion. The present study showed that fracture risk was very high in patients with osteoporosis. It highlights the need for early detection of this pathology. Keywords: Osteoporosis, axial rheumatism, fracturary risk, FRAX

BACKGROUND. Fibromyalgia is a controversial and often underreported clinical entity in routine medical practice. The present study aimed to describe its epidemiological and clinical profile in patients attending the Kinshasa University Hospital. METHODS. This is a series of clinical cases carried out in patients attending rheumatology practice at the Kinshasa University Hospital from December 2020 to March 2022. The following informations including age, sex, painful symptomatology, psychosomatic signs, the circumstances of the disease onset, factors that emphasize or reduce symptoms, the number of previous medical visits and, the impact on socio-professional life were collected. The diagnosis of fibromyalgia was defined according to the ACR 2010 criteria. Fibromyalgia was considered severe when it was associated with disability. Standard statistical tests were used to analyze the results. RESULTS. 585 patients were followed during the study period. The diagnosis of fibromyalgia was retained in 63 of them, corresponding to a frequency of 10.8%. The sex ratio was 2 in favor of women and the mean age was 50.9±12.4 years. The mean diagnostic score was 17.6±3.6. Painful manifestations were dominated by arm involvement (84.1%). Fatigue was the most common psychosomatic manifestation (93.7%). Anxiety (41.3%) dominated the basic psychic state of patients and the average of previous medical visits number was 5.2±1.6. Fibromyalgia was often triggered by emotional stress (44.4%). Quiet rest (42.9%) was the main calming factor. 60.3% of patients developped the severe form of the disease. CONCLUSION. Fibromyalgia is among common disease for which patients visit the rheumatology unit. So, it is required a special consideration from health care workers particularly rheumatologists for an early diagnosis.