BackgroundRheumatoid arthritis is a chronic disease that can cause irreversible joint damage and significant disability [1]. The announcement of this diagnosis remains one of the most unpleasant moments in the medical practice for both patients and caregivers. For the physician, whose primary mission is to provide relief, knowing that it may cause psychological distress is a challenging task.ObjectivesWe aimed to study the impact of the disease’s announcement on rheumatoid arthritis patients.MethodsWe conducted a cross-sectional study including patients fulfilling the American Congress Of Rheumatology/ European League Against Rheumatism (ACR EULAR) 2010 criteria. We collected epidemiological, clinical, biological (C-reactive protein: CRP, erythrocyte sedimentation rate (ESR), immunological status (rheumatoid factor RF and anti-citrullinated protein/peptide antibody ACPA), disease activity index (The Disease Activity Score 28 DAS 28). Patient’s experience during the announcement of diagnosis was assessed using a questionnaire.ResultsThirty patients were enrolled. There were 25 women and five men. The mean age was 67.10 ± [29-75]. The mean duration of the disease was 10.41 ± [2.5- 38] years. The mean DAS 28 VS was 4.5 ± [1.36-6.27].Among 30 patients, 66.67 % received the news with anxiety, particularly because of the chronic nature of the disease and possible multi-organ involvement. Nine patients were reassured and felt less anxious for having understood the cause of their pain. Seventy patients (56.67 %) found that the doctor was empathetic and tried to explain the therapeutic alternatives reducing their stress. However, 30% of patients (n=9) found the announcement shocking and would have preferred a gradual approach.ConclusionOur study showed stress and anxiety are common feelings for most patients, highlighting the importance of a patient-centered approach to improve initial acceptability of.their disease.Reference[1]Grajales H. [The announcement of a diagnosis in psychiatry]. Rev Infirm. mai 2022;71(281):49‑50.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

BackgroundThe parity seems to decrease the risk of auto-immune diseases like Rheumatoid arthritis (RA). The risk reduction appeared when the parity number reached two [1]. The activity of RA improved during pregnancy and flares postpartum, but the relationship of parity to RA prognosis is unclear. The impact of childbirth on disease activity is less studied.ObjectivesWe aimed to investigate the impact of parity on rheumatoid arthritis activity.MethodsWe conducted a retrospective study including patients fulfilling the American Congress Of Rheumatology / European League Against Rheumatism (ACR EULAR) 2010 criteria.We collected epidemiological, clinical, biological (C-reactive protein: CRP, erythrocyte sedimentation rate (ESR), immunological status (rheumatoid factor RF and anti-citrullinated protein/peptide antibody ACPA), and disease activity index (The Disease Activity Score 28 DAS 28). We divided our patients into two groups: group (G1): the nulliparous women; group 2 (G2): women who gave birth.ResultsNinety-two patients were enrolled. There were 14 men and 78 women. The mean age was 59.56 ± 11.7 years. The mean disease duration was 9.32 ± 8.22 years. Among 78 women, we found 50 patients with parity. The main swollen joint was 3.34 ± 3.6 in G2 versus 4.44 ± 4.04 in G1 (p=0.94). The mean painful joints were 6.74 ± 5.12 and 9 ± 9.19 (p=0.28), respectively. However, the inflammatory syndrome is higher among women in G2. The mean CRP level was 15.1 mg/l, and the mean ESR was 37.7 mm. In G1, the RF and ACPA were 131 UI/l and 281 UI/l, respectively compared with 568 UI/L and 315UI/l, respectively in G2.A significant difference was noted in the DAS28-CRP between the two groups (G2: 4.18 ±1.23 versus G1: 4.49 ± 2.5, p=0.04).However, no association was found between parity and disease activity using the DAS28-ESR.ConclusionOur study showed that parity could have a protective effect on disease activity. It seems to be associated with a lower joint count and a lower rate of RF and ACPA. However, more studies are necessary to conclude these issues.References[1]Chen WMY, Subesinghe S, Muller S, Hider SL, Mallen CD, Scott IC. The association between gravidity, parity and the risk of developing rheumatoid arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. avr 2020;50(2):252‑60.Disclosure of InterestsNone declared

Introduction Inflammation plays a crucial role in impaired bone metabolism [1]. Subchondral bone marrow oedema (BME) in Magnetic Resonance Imaging (MRI) was associated to bone mineral density (BMD) loss in adult spondyloarthritis [1]. BME was less studied in juvenile idiopathic arthritis (JIA). Objectives We aimed to study the link between MRI BME and BMD in JIA patients. Methods We conducted a retrospective study of 44 patients with JIA who fulfilled the International League of Associations for Rheumatology (ILAR) 2001 criteria. For each patient we collected the following data: age, age at the onset of JIA, JIA subtype, disease duration, C-reactive protein (CRP) and Erythrocyte sedimentation rate (ERS) levels, BMD assessed using bone densitometry and MRI. Disease activity was assessed using the JADAS score. Statistical analysis was performed using SPSS software. Results We included 28 boys and 16 girls. The mean age was 13.65 ± 4.62 years. The mean age at the onset of the disease 9.57 ± 3.97 years. The mean disease duration was 4.34 ± 3.09 years. There was enthesitis-related arthritis in 61% of the cases (n = 27), oligoarticular JIA in 14% of the cases (n = 6), polyarticular JIA in 11% of the cases (n = 5), and psoriatic arthritis in 7% of the cases (n = 3). JIA was undifferentiated in 7% of the cases (n = 3). The mean CRP and ESR were 14.42 ± 19.67 mg/l and 26.56 ± 20.87 mm, respectively. The mean JADAS was 6.6 ± 4.7. Bone densitometry was performed in 17 patients. The mean BMD and the mean Z-score were 0.961 ± 0.128 g/cm2 and -0.4 ± 1.16 standard deviation, respectively. Magnetic resonance imaging (MRI) showed BME in 52% of the patients (n = 23). Bone marrow oedema was present in the sacroiliac joints in 43% of the cases (n = 19), in the coxofemoral joints in 27% of the cases (n = 12), and in the spine in 9% of the cases (n = 4). The presence of BME was associated with a higher ESR (32.71 ± 25.71 vs 18.94 ± 10.72 mm, P = 0.032), higher JADAS (8.01 ± 5.36 vs 4.75 ± 3.29, P = 0.023), and a lower Z-score (-1.3 ± 0.77 vs 0.4 ± 0.8 standard deviation, P = 0.001). Conclusion Our study showed that MRI BME was associated with high disease activity and BMD loss in JIA patients. This result is consistent with those of Akgöl et al. [2]. Bone marrow oedema seems to predict BMD loss in JIA and should lead to optimizing the treatment. References [1]. Wang D, Hou Z, Gong Y, Chen S, Lin L, Xiao Z. Bone oedema on magnetic resonance imaging is highly associated with low bone mineral density in patients with ankylosing spondylitis. PLoS One 2017;12:e0189569. [2]. Akgöl G, Kamanlı A, Ozgocmen S. Evidence for inflammation-induced bone loss in non-radiographic axial spondyloarthritis. Rheumatology 2014;53:497–501.