[Septic oligoarthritis as a complication of rhumatoid arthritis--a case report]. / Oligoarthrite septique compliquant une polyarthrite rhumatoide--a propos d'un cas.

We present the case a 53-year-old patient followed-up since 1999, for erosive AR treated with methotrexate and glucocorticoids. In April 2000, he had an arthritis of the right knee. The identification of an enterobacter in blood culture, and synovial biopsy results permitted the diagnosis of septic arthritis. After 23 days of antibioterapy treatment, the patient had an arthritis of the left knee. The infectious origin was confirmed by synovial biopsy. The course was better after adaptation of the antibiotics. Septic arthritis is then a serious complication of AR. It requires a fast and multidisciplinary management. It can be threatenig in fragile and immunocompromised patients. The functional prognosis is especially compromised in polyarticular septic arthritis.

Osteoporosis and Crohn's disease.

UNLABELLED: Osteoporosis and osteopenia have been reported frequently in patients with inflammatory bowel disease, most notably Crohn's disease. OBJECTIVES: To determine the prevalence and risk factors of osteoporosis in patients with Crohn's disease. METHODS: Prospective study of 56 patients with Crohn's disease, 34 men and 22 women with a mean age of 32 +/- 10.4 years (18-54 years) and no history of disorders known to influence bone metabolism. Dual-energy X-ray absorptiometry measurements of bone mineral density (BMD) were obtained at the femoral neck and lumbar spine. A multivariate model including those factors significantly associated with low BMD in the univariate analysis was used to identify independent risk factors. RESULTS: Osteoporosis was found in 35.7% and osteopenia in 23.2% of patients. Low BMD was significantly associated with low body mass index (BMI), colonic involvement, and glucocorticoid therapy. Low BMI was an independent risk factor for low BMD. Malnutrition with BMI < or =18 kg/m2 was noted in 21 patients, of whom 76.2% had low BMD values, as compared to 48.6% of the patients whose BMI was >18 kg/m2 (P = 0.03, odds ratio = 3.4). CONCLUSION: Among risk factors for bone loss in patients with Crohn's disease, malnutrition plays a prominent role that deserves attention when planning treatment programs.