Behçet’s disease (BD) is a vasculitis with multisystemic manifestations. Articular involvement is frequent and benign whereas vascular complications are rare but serious and can form the onset of the disease. The assessment of the thickness of the common femoral vein wall is a new tool for the diagnosis of BD with good sensitivity and specificity. We report the case of a 52-year-old man diagnosed with BD revealed by an abdominal aortic pseudoaneurysm and a chronic monoarthritis. The first flare-up of BD can occur in men over 50 years of age. In a context of a multisystemic disease, lumbar pain should lead to the search of abdominal aortic aneurysm. The assessment of the thickness of the common femoral vein wall is accessible and should be used especially in challenging cases.

Patient: Male, 74-year-old Final Diagnosis: Secondary syphilis Symptoms: Knee pain Medication:— Clinical Procedure: — Specialty: Rheumatology Objective: Challenging differential diagnosis Background: Syphilis is a sexually transmitted infection (STI) caused by Treponema pallidum . If untreated, primary syphilis can progress to secondary syphilis, which has a characteristic rash and diverse systemic features. This report is of a case of secondary syphilis with mucocutaneous, articular, and pulmonary involvement. Case Report: A 74-year-old Moroccan man presented with an 8-week history of bilateral knee pain and swelling. On examination, he had bilateral knee effusions. Articular puncture brought an inflammatory fluid with a significant presence of white blood cells. Inflammatory markers were elevated. X-rays of both knees showed bilateral osteoarthritis with intra-articular calcification in the left knee. Nonsteroidal anti-inflammatory drugs and colchicine were prescribed, but were ineffective. A closer clinical examination of the patient revealed pigmented papules on the palms, soles, oral mucosa, trunk, and genitals. Treponema pallidum hemagglutination assay and Venereal Disease Research Laboratory results were positive in the blood (titers 1: 32) and joint fluid. A computed tomography scan of the chest revealed a focal opacity in the lateral basal segment of the right lung. The diagnosis of secondary syphilis with mucocutaneous, articular, and pulmonary involvement was made. The evolution was favorable after a single intramuscular injection of benzathine-penicillin. Conclusions: Arthritis, mucocutaneous involvement, and lung lesions can be manifestations of secondary syphilis. A detailed anamnesis, clinical examination, serology, and imaging techniques are the pillars of diagnosing this condition.

BackgroundIn addition to the extra-articular manifestations associated with spondyloarthritis such as IBD, psoriasis and uveitis, spondyloarthritis is linked to an increased risk of comorbidities.ObjectivesTo study the prevalence of comorbidities in spondyloarthritis (SPA) at inclusion and 36-month follow-up and their influence on disease activity and functional outcome in a cohort of patients followed for SPA from the Moroccan registry of biological therapies in rheumatic diseases (RBSMR Registry).MethodsData were analyzed from cohort of 194 patients with SPA from the RBSMR Registry including comorbidities (hypertension, diabetes, dyslipidemia, obesity, osteoporosis, sedentary lifestyle, gastrointestinal ulcer, smoking, depression, fibromyalgia) and disease activity scores at inclusion (M0) and at 36-month follow-up (M36).ResultsThe mean age was 40,23 ± 13,68 ans. The sex-ratio (M/W) was 1,73. 96.4 % of the patients had axial involvement, 70 % had peripheral involvement and 61.5 % had enthesitis. SPA was radiographic in 88.1 % of the cases. The mean duration of disease was 615,90 ± 349,12 weeks. 57,2% of patients had at least one comorbidity, among whom the median comorbidity count was 1 (range 1-5).Table 1.comparison between prevalence of comorbidities at M0 and M36.ComorbidityPrevalence at inclusion (M0)Prevalence at 36-month follow-up (M36)Sedentary behaviour29,4% (n=57)31,4% (n=61)Osteoporosis11,3% (n=22)13,4% (n=26)Smoking10,8% (n=21)10,8% (n=21)Hypertension5,7% (n=11)9,3% (n=18)Obesity8,2% (n=16)8,2% (n=16)Tuberculosis6,7% (n=13)11,34% (n=22)Diabetes5,2% (n=10)6,2% (n=12)Gastrointestinal ulcer2,6% (n=5)3,1% (n=6)Dyslipidemia1,5% (n=3)2,6% (n=5)Cancer0% (n=0)1,0%(n=2)Depression2,6% (n=5)2,6% (n=5)Fibromyalgia2,1% (n=4)2,1% (n=4)Table 2.Comparison between patients with or without comorbidities.ParameterPatients with at least one comorbidity (57,2%)Patients without comorbidities (42,8%)pESR (mm/h)36,2436,970,163CRP (mg/l)42,1427,000,002ASDAS-CRP3,672,500,003BASDAI5,104,500,098BASFI6,104,160,028ConclusionIn our study, the presence of comorbidities was correlated with more severe disease activity. Better management of these comorbidities may result in better outcome of patients with SPA.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

BackgroundOverweight, translated into a high body mass index (BMI), is associated with a risk of gonarthrosis, thus, this risk is increased by 15% for each increase of a unit of body mass index (BMI). (1)Various studies indicate that the association of high BMI and abdominal obesity measured by waist circumference leads to increased morbidity especially in obese. But no study has so far shown a sufficiently strong association force between waist circumference and gonarthrosis.(2,3)ObjectivesThe objective of our study is to assess the relationship between waist circumference and pain perception and gonarthrosis impact.MethodsThis work included patients followed in consultation for gonarthrosis. For each patient we specified next to the demographic data, the BMI, the waist circumference, and the existence or no pain of the knee or both. The intensity of pain was assessed by the Analog Visual Scale (EVA). Functional impact was assessed by the Lequesne index and Womac score. Knee X-rays were classified according to Kellgren Lawrence (KL) criteria.ResultsA total of 209 patients were included (24 men/185 women). The average age was 57.94± 9.01 years. The average body mass index was 25.15 ±5.47 kg/m2and the average TI was 93.45 ±12.35 cm.The average pain EVA at rest was 1.95 2.53 and at stress 7.89 ±1.30. Womac’s average score was 12.3± 8.92 and Lequesne’s average index was 6.71 3.20.WOMAC SCORE was significantly higher in gonarthrosis patients with a high waist circumference (p = 0.02).A positive correlation was found between the resting and stress pain EVA and the waist circumference of gonarthrosic patients with respectively (p=0.04, p=0.002). but it is statistically insignificant between the radiographic stages, the lesquene index and waist circumference with (p=0.11, p=0.06, respectively).ConclusionThe the waist circumference seems to be a predictive factor of the presence of gonalgie and a significant functional impact.References[1]L.Jiang, W.Tian, Y.Wang and col. Body mass index and susceptibility to osteoarthritis of the knee: meta-analysis. Rev Rhum Engl Ed 2012;2:142-148[2]Canadian Joint Replacement Registry. Total Hip and Total Knee Repla- cements in Canada: 2005 Report. Ottawa, ON: Canadian Institute for Health Information; 2005.[3]Tjepkema M, Shields M. Measured Obesity: Adult Obesity in Canada. Catalogue No. 82–620-XWE2005001 ed. Ottawa: Statistics Canada; 2005.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Introduction The Assessment of SpondyloArthritis International Society (ASAS) criteria for axial and peripheral spondyloarthritis (SpA) allow for the classification of patients with an age of onset of disease of less than 45 years. However, SpA can start after this age. This study aimed to assess the characteristics of late-onset SpA (SpA>45 years) in the Moroccan registry of biological therapies in rheumatic diseases (RBSMR). Methods A cross-sectional study was conducted using the baseline data of the RBSMR. The protocol for the original RBSMR study was reviewed and approved by the Ethics Committee for Biomedical Research Mohammed V University - Rabat, Faculty of Medicine and Pharmacy of Rabat (approval number for the study was 958/09/19, and the date of approval was September 11, 2019), and all patients had given their written consent. Patients who met the 2009 ASAS criteria for SpA were included. They were divided into two groups: early-onset SpA (≤ 45 years) and late-onset SpA (>45 years). Clinical, biological, radiological, and therapy data of the two groups were compared. Statistical analysis was performed using SPSS v25 software (IBM Corp. Armonk, NY). Parameters with a p-value ≤0.05 were considered significant. Results Our population consisted of 194 patients. Thirty-one patients (16%) had late-onset SpA. Comparison between patients with early-onset (≤45 years) and late-onset SpA (>45 years) revealed that late-onset SpA had a higher tender joint count (p=0.01), a higher swollen joint count (p=0.02), depression (p=0.00), fibromyalgia (p=0.001), hypercholesterolemia (p=0.01), and a lower frequency of coxitis (p=0.008). Logistic regression analysis confirmed that late-onset SpA was associated with a higher tender joint count (OR=0.93, CI 95%: 0.88-0.98), a higher swollen joint count (OR=0.92, CI 95%: 0.85-0.99), depression ( OR=0.19, CI 95%:0.04-0.38), fibromyalgia (OR=1.75, CI 95%: 1.74-17.85), and a lower frequency of coxitis ( OR=0.29, CI 95%: 0.11-0.75). Conclusion As life expectancy increases, late-onset SpA will become increasingly common. It is therefore imperative to determine its characteristics. In the RBSMR study, late-onset SpA was associated with a high number of tender and swollen joints, depression, fibromyalgia, and a lower frequency of coxitis.