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Background:The pathological class of lupus nephritis (LN) may change to a different class during the course of the disease. Renal biopsy is repeated is repeated in many patients during a flare but there is there is no agreement about systematically recommending them because proliferative lesions on their original biopsy rarely switch to a pure nonproliferative nephritis during a flare. However, renal rebiopsy may be useful in some cases to make appropriate adjustments or changes of treatment.Objectives:To analyze the impact of renal rebiopsy on the therapeutic approach in patients with previous histological diagnosis of LN who experience a worsening in the clinical parameters of renal involvement.Methods:Retrospective study of patients with histological diagnosis of NL subjected to at least one renal biopsy. We studied the demographic, clinical, histopathological variables of the first and subsequent renal biopsies, received treatment and the therapeutic modifications in relation to the result of the rebiopsies.Results:We analyzed 35 patients diagnosed with LN between 1978 and 2017. 9 of them had been rebiopsied at least on one occasion and made a total of 11 rebiopsies (7 patients with a rebiopsy and 2 patients with 2 rebiopsies). All patients were female and Caucasian, except for a Hispanic woman, with a mean age at the time of the rebiopsy of 31 ± 12 years (14-55). The mean serum creatinine at the time of the first re-biopsy was 0.8 ± 0.17 mg/dl (0.5-1.06) and in the second, 1.18 ± 0.05 mg/dl (1.15-1.23). The fundamental indication for the rebiopsy was the increase in proteinuria, up to non-nephrotic range in 64% of the patients and within the nephrotic range in 36%. In comparison with the previous biopsy, 3 of the rebiopsies (27%) showed evolution from a non-proliferative to a proliferative form (from II to III, from II to IV and from V to V + IV). 4 of the rebiopsies (36%) started from a proliferative class and changed class but within these forms (3 from IV to III and and 1 from III to IV). The remaining 4 rebiopsies (27%) showed no change in the histological type. Regarding the baseline biopsy, we observed a decrease in the index of activity of the rebiopsies (5.4 ± 2.2 vs 3.4 ± 2.5, p = 0.017) and an increase in the chronicity index (0.8 ± 0.7 vs 2.9 ± 3.2, p = 0.027). In all cases, therapeutic modifications were carried out. In 9 cases (82%) the immunosuppression was increased and in two of them (18%) it was decreased.Conclusion:The repetition of renal biopsy in cases of LN with clinical data of renal deterioration is relevant. The change of histological class and the evolution of activity and chronicity indexes support the decision to increase immunosuppression and are fundamental to diminish it.References[1] Narváez J, et al. The value of repeat biopsy in lupus nephritis flares. Medicine (Baltimore). 2017;96:e7099.Disclosure of Interests:None declared

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Background:Coxarthrosis is the first cause of mechanical pain and functional limitation of the hip joint, however its prevalence in subjects over 65 years is much higher than the incidence of these symptoms so its causal link is not complete. In a young population, mechanical groin pain of acute origin is usually linked to periarticular processes mainly related to adductor muscles, psoas and tendons with pertrocanteric entheses. In the routine approaches of these patients, when they consult, the simple radiological study is included and it is usually treated with NSAIDs, assuming tendinopathy as a diagnostic process.Objectives:The purpose of this study is to determine the ultrasound characteristics of the coxofemoral joint of patients who consult for acute inguinal pain, correlate it with its clinical presentation and propose a reasoned strategy for its management.Methods:We reviewed the clinical records of patients under the age of 50 who consulted for direct non-traumatic hip joint pain. Only cases with less than one week of evolution were included. Patients who consulted on weekends or in the afternoon were not included in this register because of the lack of immediate ultrasound study during these periods of time. We excluded those patients who, during the consultation, acknowledged having used anti-inflammatory drugs in the last 24 hours and those whose records are incomplete. The ultrasounds were performed with a portable Logiq e ultrasound machine, equipped with a linear probe of up to 12MHz.Results:Between 2014 and 2017, 211 patients under 50 years of age consulted for non-traumatic mechanical groin pain. Excluding patients who consulted outside of the immediate ultrasound study access hours, who had recently taken NSAIDs and whose clinical records were incomplete, we reviewed 116 clinical and image records. The mean age of the patients whose records were included was 37.8 SD 8.5. The mean time, in days, between the consultation and the onset of symptoms according to history constancy was 4 SD 2. 59 subjects were male (50.9%). In the physical examinations described in the reports, 29 patients (25%) presented painful passive manoeuvres, 38 (32.8%) presented painful active manoeuvres, and 22 (19%) could not maintain standing due to the impossibility of loading due to coxofemoral pain. Regarding the ultrasound findings, 5 patients presented unequivocal capsular distension at the level of the upper anterior labrum (4.3%) and 32 (27.6%) presented distension of the anterior recess. One patient with capsular distension was finally diagnosed with ONA and another with APso.Abstract THU0503 – Table 1 summarizes the prevalence of clinical findings depending on the existence or not of distension of the anterosuperior labrum or of the previous recess in the ultrasound scan performed.Conclusion:Our results show that in the studied population (<50 years old, non-traumatic coxofemoral pain of sufficient intensity to be consulted in the emergency department in less than 7 days of evolution) synovitis is a finding present i...

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