[Involvement of the hip in rheumatoid arthritis]

Involvement of the hip occurs in 15 to 20% of the rheumatoid arthritis. It engages the functional prognosis. Our objective was to specify the frequency of coxitis among our patients, the ground of its which has occurred and its clinical and radiological characteristics. We conducted a cross study including seventy patients with rheumatoid arthritis according to American college of rheumatology criteria. All patients had a clinical exam with measurement of index of evolutivity and of severity from RA, and radiographs of pelvis. We included 57 women and 13 men with rheumatoid arthritis, the mean age was 35,38 +/- 11,21 year, and mean duration of rheumatoid arthritis was of 11,82 +/- 6,9 years. The diagnosis delay was 2 years. Eleven cases of coxites were noted including 7 women and 4 men. The mean duration of the coxitis was 3,66 +/- 4,24 years with a diagnosis delay of 7,25 +/- 7,75 years. Involvement was bilateral in seven cases [63,63%]. The radiological analysis had objectivised a pinching in 11 cases, erosions in seven cases, an acetabuli protrusion in 4 cases and a secondary osteoarthritis in six cases. Only 2 patients had hip joint replacements. In our rheumatoid arthritis the coxitis is common, correlated with disease duration, delay diagnosis and severity of rheumatoid arthritis. It is often bilateral. It can be very invalidating, justifying an early and correct treatment

[Reactive arthritis]

Study the frequency of the reactive arthritis, and specify its clinico-biological and therapeutic characteristics with a review of the literature. We conducted a retrospective study including 22 cases of reactive arthritis. All patients had a clinical exam and serology of the germs accused according to clinical data. Urethral prelevement and coprocultures were carried out in the event of sign of orientation. Eighteen men and four women were included, whose mean age was 34 +/- 11, 79 years. The mean duration of reactive arthritis was of 7,95 +/- 5,89 years with a diagnostic delay of 0,79 +/- 1,55 years. Origin of infection was identified in 12 cases [genital in 10 cases and digestive in two cases]. The clinical presentation was as follows: monoarthritis in six cases, oligoarthritis in 11 cases, polyarthritis in four cases. The heel pain was present in six cases, and the ocular manifestation in form of iritis was noted in four cases. Serology of Chlamydia was positive in 16 cases. Genital taking had isolated a Chlamydia and a mycoplasma in two cases. The corproculture had isolated a shigella in two cases. The treatment comprised anti-inflammatory drugs in 22 cases, antibiotics in 18 cases and intra-articular steroids in 10 cases. Evolution to ankylosing spondylitis was notes in 12 cases [10 men and 2 women]. Reactive arthritis with Chlamydia seems more frequent at the men. The evolution is often towards to ankylosing spondylitis. A prospective study on a large scale could be able to confirm these data