Rheumatoid arthritis is an autoimmune mechanism disease that preferentially affects women. Remission from rheumatoid arthritis has often been associated with pregnancy. A 29-year-old woman presented with symmetrical inflammatory polyarthralgias of the large and small joints with morning stiffness estimated at 5 hours, and the Visual Analogue Scale at 80/100 associated with the joint swelling onset 12th week of amenorrhea. She has no medical history, third pregnancy, and no fetal loss has been reported. The physical examination of the day objectified five painful joints and two swollen joints. Disease activity was moderate. There was a biological inflammatory syndrome with a C-Reactive Protein (CRP) at 37.9 mg. Rheumatoid factor was positive at 214 IU (Standard <14 IU), anti-citrullinated peptides antibodies at 99.6 IU (Standard <17 IU). The pregnancy revealed rheumatoid arthritis positive to rheumatoid factor and citrullinated cyclic anti-peptide antibodies. 

Introduction - The diagnosis of rheumatoid arthritis remains a challenge because sickle cell disease can result in various rheumatological manifestations, including joint and bone pain. The concomitant presence of rheumatoid arthritis and sickle cell disease makes the therapeutic management of both conditions problematic. Observation - A 24-year-old man, a nurse by profession, has been followed for 10 years for homozygous sickle cell disease at the Sickle Cell Disease Research Center (CRLD) of Bamako, Mali. He has presented for 8 months symmetrical polyarthritis with morning stiffness of 3 hours, distinct from the usual vaso-occlusive crisis. The Analog Visual Scale was estimated at 80/100. He reported unquantified weight loss and asthenia. The physical examination showed a deformity in bilateral ulnar deviation, flexion of the right elbow, twelve painful joints, and five swollen joints. Normochromic normocytic anemia (hemoglobin 8.3g/dl), inflammatory syndrome with C - Reactive Protein (CRP) 130.91 mg, and Sedimentation Rate (ESR) 72mm at the first hour were noted. Rheumatoid Factor was weakly positive at 21.3 IU and Anti Citrullinated Peptide Antibodies at 385.2 IU. The radiography discovered bilateral erosive carpets without associated tarsitis and osteonecrosis of both femoral heads. The diagnosis of a very active immunopositive erosive rheumatoid arthritis meeting the criteria of ACR / EULAR 2010 was retained. A treatment based on prednisone 10 mg per day was initiated, associated with methotrexate at a dosage of 15 mg weekly in single-dose, folic acid, calcium, and vitamin D. Conclusion - The coexistence of rheumatoid arthritis in sickle cell patients makes the diagnosis of polyarthritis difficult.

Tuberculosis is endemic in our countries and multiple modes of revelation. The cervical Pott's disease is the rarest spinal location. Spinal cord compression, retropharyngeal and epidural abscess are serious complications that can engage the prognosis. We report a case of cervical Pott's disease revealed by dysphagia due to a retropharyngeal abscess in a patient of 34 years has been the victim of the oropharynx injury by a fish bone. This observation reveals one of the many facets of tuberculosis.Keywords: Cervical Tuberculosis, Dysphagia, Fish bone