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BackgroundJuvenile idiopathic arthritis (JIA) is characterized by widely heterogeneous clinical course and outcomes. Hips are the most commonly affected joints in severe uncontrolled JIA.ObjectivesThe aim of our study was to determine the prevalence and associated factors of hip involvement in Tunisian JIA patients.MethodsA retrospective and observational monocentric study including children with JIA according to the ILAR was conducted in the Rheumatology department of Sousse, Tunisia. We compared the disease parameters between the two groups with and without coxitis.ResultsWe included 55 children (28 girls and 27 boys). The mean age was 13.6 years. The predominant subtypes of JIA were the seronegative polyarticular JIA (38.2%), and the seronegative oligoarticular form and juvenile spondyloarthritis (16.4% each). Biological inflammatory syndrome was found in 65.5% of cases. The mean ESR and CRP was 42.4 mm/h and 28.8 mg/l respectively. Hip involvement concerned 30.9% of the patients (n=17) and was bilateral in 64.7% of cases (n=11). Coxitis occurred on average 10 years after the JIA onset. The mean Lequesne index was 12. Hip radiographs were normal in 40% of cases. Magnetic resonance imaging was performed in 25% of cases and revealed synovitis in 70% of cases. Overall, 61.8% of patients had medical treatment combining non steroidal anti-inflammatory drugs and rehabilitation. Only two patients had local infiltration with Hexatrione. In 12.7% of cases (7 cases), a total hip replacement was necessary. Hip involvement was significantly associated with younger age at onset (p=0.02), polyarticular subtype of JIA (p=0.04) and with the presence of biological inflammatory syndrome (p=0.03). However, coxitis was not significantly associated with gender, the duration of JIA progression, extraarticular manifestations, structural damage or the different used treatments.ConclusionOur study showed that hip involvement is frequent among Tunisian patients with JIA. Coxitis was associated with the polyarticular subtype, with biological inflammatory syndrome and younger age at onset of JIA.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

BackgroundBone lymphoma is rare disease, its diagnosis is usually delayed due to the unspecefic clinical and radiological signs.ObjectivesOur objective was to describe the clinical, biological and radiological aspects of bone lymphoma to optimize diagnostic approaches.Methods14 cases of bone lymphoma were collected in the Rheumatology Department of Sousse between 2001 and 2022.ResultsThe mean age was 42 with a sex ratio of 1. The main symptom in 14 patients was pain associated with deterioration of general condition (10 cases), swelling of lymph glands (8 cases), fever and night sweats (6 cases), neurological signs (6 cases) with a diagnostic delay of 4 months.In biology, 13 patients had biological inflammatory syndrome, 2 of the 14 patients had hypercalcemia with a mean of 2.85, 6 patients had elevated LDH and 6 had elevated PAL. The abnormalities of the CBC were anemia in 10 cases, leukopenia in 1 case, hyperleukocytosis in 6 cases.On imaging, the lesions were single in 6 cases and multiple in 8 cases. A lytic process was found in 9 cases, osteocondensation in 3 cases and mixed lesions in 2 cases. Cortical rupture was noted in 3 cases. The soft tissues were infiltrated in 8 cases. The sites were vertebral (8 cases), sacrum (2 cases), iliac (1 case), long bone (3 cases).MRI showed a T1 hypo signal and T2 hyper signal in all cases, bone scintigraphy was performed in 6 patients and showed hyperfixation in 5 cases and a heterogeneous aspect in 1 case.A bone or lymph node biopsy was performed in all 14 patients, confirming the diagnosis and showing Hodgkin’s lymphoma in 6 cases and non-Hodgkin’s lymphoma in 8 cases, 7 of which were diffuse large-cell B lymphomas.ConclusionDue to the rarity and the various clinical and radiological presentations of bone lymphoma, the diagnosis may be difficult which is why the biopsy so important.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.