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Abstract Background The prevalence of back and neck pain is common in children and adolescents, and in some series the numbers are alarming. Various risk factors have been identified, although some are controversial. Objective To determine the prevalence of neck and back pain in children and adolescents and to investigate the potential association with various risk factors identified in the literature. Methods We established a questionnaire targeting parents of children and adolescents aged between 6 and 18 years old in Tunisia. The recruitment of participants was done online using the Google Forms application. The questionnaire was divided into 2 parts: Part one collected the sociodemographics characteristics of the participants : age, gender, body mass index (BMI), exposure to passive smoking, the practice of a physical activity, puberty status and age at puberty if applicable, type and weight of the schoolbag, mean daily time spent on electronic devices, type of school the child attends (private/public), mode of transport from home to school, parental history of neck and/or back pain (mid or low back pain (LBP)), posture of the sitting position of the child, and finally whether the child reports neck/ back pain. The second part was aimed at parents whose child reported neck and/or back pain. We asked about the weekly frequency of neck/back pain, school absenteeism due to neck/back pain, whether it prevented the child from practicing physical activity and, finally, whether the child had ever seen a doctor/chiropractor/physiotherapist for their neck/back pain. Results Eighty-eight children (45 females, 43 males) were enrolled. Mean age was 11.9 ± 3.8 years [6–18]. Mean BMI was 18.8 ± 4.2 [15.8–35.5]. Thirty-four (38.6%) were pubescent. Twenty-five (28.4%) children were exposed to passive smoking. Parental history of spine pain was found in 58% of cases. A poor sitting position was noted in n = 49 (55.7%). Mean daily screen time was 88.3 ± 75.56 min [0-360]. Prevalence of spine pain was 44% (n = 39) distributed as follows: neck pain (n = 21, 23.8%), mid back pain (n = 15, 17%), LBP (n = 26, 29.5%), neck, mid back and low back pain (n = 4, 4.5%) Professional help seeking for spine pain in children was reported by 15 participants (25.3%). Among them, 20.3% visited a physician and 5% consulted a chiropractor or physiotherapist. A significant correlation was found between spine pain and age (p = 0.006) and BMI (p = 0.006). A significant association was found between LBP and exposure to passive smoking, puberty status, type of school bag and poor posture. A positive parental history of spine pain was significantly associated with the presence of spine pain in their children with p = 0.053 (neck pain), p = 0.013 (back pain) and p

Objectives Shared decision-making between rheumatologists and patients has become an overarching principle in current treatment recommendations in rheumatoid arthritis (RA). Therefore, in the present study, we aimed to assess the satisfaction of patients with RA with their treatment and to investigate the associated factors. Material and methods A cross-sectional study was carried out in the Rheumatology Department of Mongi Slim Hospital. We included adults with RA receiving their current disease-modifying anti- rheumatic drugs for at least 12 months. Satisfaction among patients was assessed by the Treatment Satisfaction Questionnaire for Medica-tion (TSQM) and it was defined by a score ≥ 80%. The factors indirectly influencing patient satisfac-tion that were assessed were: satisfaction with medical care management, disease activity, function-al impact, professional impact, and the impact of RA. Multivariable regression analysis was applied to determine the predictors of satisfaction. Results We included 70 patients (63 female/7 male) with a mean age of 57.8 ±10.6 years. The mean disease duration was 13.71 ±7.2 years. Mean TSQM scores were 65.42 ±14.77 for convenience, 68.71 ±18 for effectiveness, 70.60 ±24.5 for side effects, and 67.95 ±17.10 for global satisfaction. Satisfaction rates were: 20% for convenience, 39% for effectiveness, 46% for side effects and 30% for global satisfaction. In multivariable analysis, the predictors of global dissatisfaction were Rheumatoid Arthritis Impact of Disease (RAID) overall score (p = 0.003) and the degree of physical difficulties (p = 0.001). Satisfac-tion with the physician was correlated with better global satisfaction (p = 0.029). Difficulties in adapt-ing to RA (p = 0.043) and current treatment with biologics (p = 0.027) were predictors of dissatisfaction with convenience. Predictors of dissatisfaction with efficiency were the RAID over-all score (p = 0.032) and the difficulties of adapting to RA (p = 0.013). The predictors of satisfaction with side effects were a lower degree of interference with domestic work (p = 0.02) and better in-volvement of the patient in the treatment decision (p = 0.014). Conclusions The satisfaction with the attending physician, the participation in the treatment decision, and the impact of RA seem to influence treatment satisfaction the most. These data suggest that a better understanding of patients’ medical needs and preferences would improve satisfaction outcomes.

Ultrasonography (US) emerged as a useful imaging tool in the diagnosis of gout. However, its accuracy is still unclear. We conducted a systematic review to evaluate the performance of US in diagnosing gout. We systematically reviewed PubMed database, and all the references of eligible articles were manually screened for additional relevant papers. Studies were included if they (1) examined the performance of US in diagnosing gout, (2) used a cross-sectional design in patients presenting with acute or chronic arthritis where gout was suspected, and (3) confirmed the diagnosis of gout using microscopic identification of monosodium urate crystals as the gold standard. Seven studies were included in the present systematic review. We evaluated the diagnostic properties of three typical US signs of gout: double contour (DC), tophi, and aggregates. The sensitivity and specificity of DC for gout varied, respectively, from 42% to 87.8% and 64.1% to 97%. The sensitivity of tophi for gout was between 19% and 46% and its specificity between 93% and 100%. The sensitivity and specificity of aggregates for gout ranged, respectively, between 30.3% and 78.9% and 65% and 90.9%. When any of these US features was present, the sensitivity for the diagnosis of gout increased up to 96% while the specificity decreased to 68%. Inversely, when all three signs were observed, the specificity tended to 100% but with a poor sensitivity of 17%. US had high specificity for the diagnosis of gout in patients presenting with undifferentiated arthritis. Its sensitivity depends on which US signs are taken into account and the joints being assessed.

IntroductionObesity is a growing and debilitating epidemic worldwide that is associated with an increased inflammation. It is often linked to rheumatic diseases and may impact negatively their natural history. The use of bariatric and metabolic surgery (BMS) has increased thanks to its positive effect on major comorbidities like diabetes type 2. This systematic review provides the most up-to-date published literature regarding the effect of BMS on outcomes in rheumatoid arthritis.MethodsThis systematic review followed the preferred reporting items for systematic reviews guidelines. Original articles from Pubmed, Embase and Cochrane, published until June 16th 2023, and tackling the effect of BMS on disease outcomes in patients with RA were included.ResultsThree studies met the inclusion criteria. They were published between 2015 and 2022. The total number of RA patients was 33193 and 6700 of them underwent BMS. Compared to non-surgical patients, weight loss after BMS was associated with lower disease activity outcomes at 12 months (pConclusionTo conclude, published data indicate that BMS seems a promising alternative in reducing RA disease activity as well as morbidity and mortality in patients with obesity.

Abstract Progressive pseudorheumatoid dysplasia can be confused with juvenile idiopathic arthritis. Treatment is mainly symptomatic and the prescription of immunosupressive agents is unnecessary. Surgery may be indicated at advanced stages of the disease.

Abstract Extramedullary hematopoiesis (EMH) can rarely involve the epidural space, leading to spinal cord compression syndrome. No treatment guidelines have been established yet.