Inflammatory Arthritis In Adults Research Articles

Identification of SOCS3 and PTGS2 as new biomarkers for the diagnosis of gout by cross-species comprehensive analysis

BackgroundGout is the most common inflammatory arthritis in adults. Gout is an arthritic disease caused by the deposition of monosodium urate crystal (MSU) in the joints, which can lead to acute inflammation and damage adjacent tissue. Hyperuricemia is the main risk factor for MSU crystal deposition and gout. With the increasing burden of gout disease, the identification of potential biomarkers and novel targets for diagnosis is urgently needed. MethodsFor the analysis of this subject paper, we downloaded the human gout data set GSE160170 and the gout mouse model data set GSE190138 from the GEO database. To obtain the differentially expressed genes (DEGs), we intersected the two data sets. Using the cytohubba algorithm, we identified the key genes and enriched them through GO and KEGG. The gene expression trends of three subgroups (normal control group, intermittent gout group and acute gout attack group) were analyzed by Series Test of Cluster (STC) analysis, and the key genes were screened out, and the diagnostic effect was verified by ROC curve. The expression of key genes in dorsal root nerve and spinal cord of gout mice was analyzed. Finally, the clinical samples of normal control group, hyperuricemia group, intermittent gout group and acute gout attack group were collected, and the expression of key genes at protein level was verified by ELISA. ResultWe obtained 59 co-upregulated and 28 co-downregulated genes by comparing the DEGs between gout mouse model data set and human gout data set. 7 hub DEGs(IL1B, IL10, NLRP3, SOCS3, PTGS2) were screened out via Cytohubba algorithm. The results of both GO and KEGG enrichment analyses indicate that 7 hub genes play a significant role in regulating the inflammatory response, cytokine production in immune response, and the TNF signaling pathway. The most representative hub genes SOCS3 and PTGS2 were screened out by Series Test of Cluster, and ROC analysis results showed the AUC values were both up to 1.000. In addition, we found that PTGS2 expression was significantly elevated in the dorsal root ganglia and spinal cord in monosodium urate(MSU)-induced gout mouse model. The ELISA results revealed that the expression of SOCS3 and PTGS2 was notably higher in the acute gout attack and intermittent gout groups compared to the normal control group. This difference was statistically significant, indicating a clear distinction between the groups. ConclusionThrough cross-species comprehensive analysis and experimental verification, SOCS3 and PTGS2 were proved to be new biomarkers for diagnosing gout and predicting disease progression.

Considerations for Choosing First-Line Urate-Lowering Treatment in Older Patients with Comorbid Conditions.

Gout is the most common inflammatory arthritis in adults. The prevalence of gout increases with age. Urate-lowering treatment (ULT) among older patients is often challenging in that patients frequently suffer insufficient effectiveness or adverse events due to comorbidities, concurrentmedications, and altered pharmacokinetics. The large-scale randomized controlled trials (RCTs) directly investigating gout patients regarding cardiovascular (CV) safety have only recently been introduced; CARES and FAST compared the CV safety of the two xanthine oxidase inhibitors (XOis), febuxostat versus allopurinol, in patients with gout. Based on the CARES trial that showed CV concerns with febuxostat, the current international guidelines recommend allopurinol as first-line ULT in gout, while preserving other agents as a second-line treatment, despite a higher potency of febuxostat. XOis would be more suitable than uricosurics to treat older patients with gout due to the high prevalence of chronic kidney disease (CKD) in older patients. However, allopurinol alone might not achieve the target serum uric acid levels below 6 mg/dL and CKD might confer an increased risk of allopurinol induced cutaneous adverse reactions in older patients. Furthermore, as well as the later analysis of CARES participants who were lost to follow-up, data from the FAST trial and real-world studies suggest non-inferior CV safety for febuxostat compared to allopurinol even in the presence of CV diseases. Thus, febuxostat use in older patients with renal impairment may be more positively considered. The combination therapy of a novel uricosuric, verinurad, plus febuxostat reduced albuminuria in hyperuricemic patients with type 2 diabetes and CKD in a phase 2a trial, and further RCTs are awaited. Finally, the sodium-glucose cotransporter-2 inhibitor class of oral hypoglycemic agents, known to exert beneficial CV and renal effects independent of glycemic control, have shown a uricosuric effect and could be used as adjunctive therapy in older patients with cardiorenal comorbidities.

Monosodium urate deposition in the lumbosacral spine of patients with gout compared with non-gout controls: A dual-energy CT study

BackgroundGout is the most common cause of inflammatory arthritis in adults. Gout predominantly affects the peripheral joints, but an increasing number of published cases report gout affecting the spine. We used dual-energy CT (DECT) to assess the prevalence of monosodium urate (MSU) deposition in the spine of gout patients compared to controls, and to investigate whether gout or spinal MSU deposition is associated with low back pain. Methods25 controls and 50 gout subjects (non-tophaceous and tophaceous) were enrolled. Demographics, gout history, Aberdeen back pain score, serum urate (sU), ESR and CRP were ascertained. Subjects underwent DECT of the lumbosacral spine, which was analyzed using manufacturer's default post-processing algorithm for MSU deposition as well as a maximally-specific algorithm to exclude potential artifact. Findings72 subjects were analyzed (25 control, 47 gout). Gout subjects had greater BMI, serum creatinine, sU, CRP, and ESR versus controls. Using the default algorithm, MSU-coded volumes in the lumbosacral spines were significantly higher among the gout subjects vs controls (p = 0.018). 34% of gout subjects vs 4% of controls had spinal MSU-coded deposition (p = 0.0036). Applying the maximally-specific DECT post-processing algorithm, 18% of gout patients vs 0% of controls continued to demonstrate spinal MSU-coded deposition (p = 0.04). Non-tophaceous and tophaceous subjects did not differ in spinal MSU-coded deposition or sU. Gout patients had more back pain than controls. InterpretationA significant subpopulation of gout patients have spinal MSU-coded lesions. Default and maximally-specific MSU post-processing algorithms yielded different absolute MSU-coded volumes, but similar patterns of results. Gout patients had more back pain than controls. Spinal MSU deposition in gout patients may have implications for clinical picture and treatment.

Association between Clinical Use of Colchicine and Risk of Type 2 Diabetes Mellitus among Gouty Patients: A Nationwide Cohort Study.

Background: Gout is the most common form of inflammatory arthritis in adults. Even though a link between gouty arthritis and type 2 diabetes mellitus (T2DM) has been reported, there is a limited understanding of the association between the anti-inflammatory agent colchicine and the risk of T2DM. This aim of this study was to assess the association between the use of colchicine and the risk of T2DM in an Asian cohort. Methods: A retrospective cohort study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan from 2000 to 2013. The study cohorts comprised 3841 gouty patients using colchicine (the exposed cohort) and 7682 gouty patients not using colchicine (the unexposed -cohort). The primary outcome was incident DM. The hazard ratios (HRs) and 95% confidence intervals (CIs) derived from a Cox proportional regression model were used to assess the association between colchicine use and the risk of diabetes. Results: The cumulative incidence of T2DM was significantly lower in the exposed cohort (18.8%) than in the unexposed cohort (25.0%). The risk of T2DM was significantly lower in colchicine users than in non-users (adjusted HR, 0.74; 95% CI, 0.36–0.87). The inverse relationship between colchicine use and diabetes risk remained consistent across sex and age groups. Conclusions: This cohort study provides longitudinal evidence that the use of colchicine is associated with a reduced risk of T2DM. This conclusion, however, needs to be interpreted cautiously given the lack of body mass index data in the NHIRD. Further studies are needed to determine the clinical implications of this study.

Genetics of hyperuricemia and gout: Insights from recent genome-wide association studies and Mendelian randomization studies.

ABSTRACTGout is the most common form of inflammatory arthritis in adults. Elevation serum uric acid (SUA) concentration is known to be the key to gout pathogenesis. Since the first genome-wide association study (GWAS) for SUA was performed in 2007, the number of gene loci known to be associated with hyperuricemia and gout has grown rapidly. GWASs and Mendelian randomization studies have also reported numerous novel results regarding the genetics of hyperuricemia and gout since 2018. We concisely review recent advances in scholarship on the effects of genetics on hyperuricemia and gout risk. We also review data from genetic association studies in Taiwan and perform GWASs of SUA levels among Taiwan Biobank participants.

Type 2 diabetes mellitus and gout

Gout is the most common inflammatory arthritis in adults and has continued to increase in prevalence over the past decades. Gout is characterized by hyperuricemia with the obligatory crystallization of urates and an associated inflammatory reaction, as well as metabolic effects caused, among other things, by these processes. In particular, the diagnosis of gout is identified with a high risk of carbohydrate metabolism disorders, which is 2 times higher than the population risk: according to various sources, from 21 to 26% of patients with gout have type 2 diabetes mellitus (DM 2). However, the role of uric acid and urate-lowering drugs in its development in patients with gout remains controversial. The possibility of influencing the risk of developing diabetes mellitus type 2 of chronic inflammation, the activity of interleukin-1β and other pro-inflammatory cytokines, hyperuricemia, xanthioxidase and other factors associated with gout is discussed. It is possible that the level of uric acid is associated with diabetes and other metabolic diseases, causing pathophysiological changes not only through inflammation, but also oxidative stress, damage to the vascular endothelium. It is also suggested that gout and DM 2 may share genetic markers. The interrelation of violations of purine and carbohydrate metabolism prompts the search for drugs that have a simultaneous positive effect on purine and carbohydrate metabolism. However, it is not clear what the level of uric acid should be considered as a risk factor, there are conflicting data on the possibility of reducing the risk of developing diabetes with various anti-gout therapies.

Risk of dementia in gout and hyperuricaemia: a meta-analysis of cohort studies

ObjectivesGout, characterised by hyperuricaemia with monosodium urate crystal formation and inflammation, is the most common inflammatory arthritis in adults. Recent studies have found that elevated uric acid levels are related...

P004 Rheumatologist vs pathology department: correlation of crystal identification in synovial fluid analysis

Abstract Background/Aims Crystal arthritis is the commonest inflammatory arthritis in adults. Diagnosis relies mostly on the correct identification of crystals under red-compensated polarized microscopy with assessment of birefringence. This is done routinely in our department when opportunity arises. Failure to appropriately identify crystals may result in lengthy hospitalisations, complications, avoidable repeated urgent visits, and unnecessary cost. We aimed to examine the agreement between rheumatology vs pathology-based microscopy for crystal analysis. There is currently no standardized pathway for synovial fluid crystal analysis in our tertiary centre in Dublin. Methods A prospective study at Mater Misericordiae University Hospital - Dublin, was started in Dec 2019. Synovial fluid samples were obtained from acutely inflamed joints where clinically indicated. Fresh samples which were found to contain crystals (MSU or CPP) by a rheumatology consultant or trained registrar using compensated polarized microscopy, were also simultaneously sent to our pathology laboratory to receive similar analysis. Ethical approval was granted and all patients consented for their joint fluid to receive double analysis. Results 33 samples have been analysed to date. 13 samples of MSU crystals and 20 CPP crystals (table 1). Both rheumatologist and pathologist agreed on all but only one MSU sample. The pathologist identified CPP crystals only on 2/20 samples. The fluid analysis was carried out within the same working day by rheumatologist Vs. median of 2.3 working days for the result by the pathologist. Conclusion The study showed a high agreement between rheumatologists and pathologists on identification of MSU crystals (92%), but very poor agreement on CPP crystals (only 10%). A quality improvement project is currently underway to address this issue and bridge the gap. Majority of Rheumatologists don't routinely perform crystal analysis using polarized microscopy and rely on their local cellular pathology lab for the results. Rheumatologists need to liaise with their local pathologists to optimise and streamline the process of crystal microscopy specially CPP crystals. P004 Table 1:crystals samples analysed through rheumatology and pathologyCPPD positiveMSU positiveRheumatologist2013Pathologist212Total2013 Disclosure A. Abdalla: None.

P100 Acute crystal arthritis: a leading cause of hospital admission, yet poorly recognised and mistreated

Abstract Background/Aims Crystal arthritis is the commonest inflammatory arthritis in adults. A common mimic is septic arthritis. Without appropriate synovial fluid analysis, a mis-diagnosis of sepsis can be made with resultant unnecessary hospitalization, inappropriate intravenous antibiotic therapy and excess cost. Such cases are frequently described as ‘culture-negative’ septic arthritis. We aimed to examine and analyse the cases of acute arthritis requiring acute hospital admission in a tertiary referral centre in Dublin. Methods A retrospective review of database between Jan - Dec 2019 at the Mater Misericordiae University Hospital, Dublin, was carried out. All cases of acute arthritis requiring acute hospital admission were identified. Cases treated at the Emergency Department, Acute Medical Unit or Outpatients which did not require hospital admission were excluded. Results 30 patients were identified during this period, 16 (53%) had an ultimate diagnosis of crystal arthritis, 8 (27%) had confirmed septic arthritis and 6 (20%) had other arthritides (e.g. haemoarthrosis). The median age for crystal arthritis was significantly higher (85.5 y) compared to septic arthritis (47 y). Apart from age, the clinical profile and biomarkers for crystal and septic arthritis were comparable. The majority of crystal arthritis cases were due to pseudogout (69 %), ultimately diagnosed by rheumatology. Septic arthritis led to more days in hospital than crystal arthritis (median 14 vs 5.5 days). All 30 patients received IV antimicrobial therapy for presumed septic arthritis. Conclusion This retrospective study showed crystal arthritis, especially pseudogout, was the commonest cause of hospital admission (53%) with acute arthritis particularly among elderly patients. Accurate diagnosis by synovial fluid analysis with appropriate equipment is extremely useful in the assessment of these cases. More awareness and training among orthopedic, emergency and acute clinicians is needed in order to avoid unnecessary admissions and interventions. Disclosure A. Abdalla: None.

YouTube as a source of information on gout: a quality analysis

YouTube is a popular video-sharing platform commonly visited by patients and healthcare professionals for medical information. Gout is the most frequent cause of inflammatory arthritis in adults. However, the accuracy and quality of gout-related information on YouTube are not fully known. Thus, the aim of this study was to assess the reliability and quality of YouTube videos pertaining to gout. A YouTube search was conducted using the keywords “gout”, “gout arthritis”, “gout treatment”, and “gout diet”. Of the 240 videos screened, 114 that met the inclusion criteria were included in the study. The number of days since upload, number of views, likes, dislikes, comments and duration of the videos were recorded. A Modified DISCERN tool and the Global Quality Scale (GQS) were used to evaluate the reliability and quality of the videos. Of the 114 analyzed videos, 87.72% were deemed as useful while 12.28% contained misleading information with higher viewership. The most common topic was “gout diet”. The majority of the videos demonstrated high quality (57.89%), followed by intermediate quality (28.95%) while the percentage of low-quality videos was 13.16%. Videos posted by academic institutions/professional organizations and physicians had higher modified DISCERN and GQS scores indicating higher reliability and quality. This study demonstrated that the majority of YouTube videos on gout provide useful information. However, physicians should be aware of the limited nature of YouTube and correct any misinformation during face-to-face meetings. YouTube should consider avoiding misleading videos using validity scales such as modified DISCERN and GQS.

GAMBARAN KARAKTERISTIK RESPONDEN RHEUMATOID ARTHRITIS PRE TREATMENT GINGER OIL (Zingiber Officinale Rosc) DAN TERAPI RESISTED ACTIVE MOVEMENT

Rheumatoid arthritis (RA) is the most common autoimmune inflammatory arthritis in adults. Pharmacological treatment is quite effective to overcome it, but in some cases, especially in elderly RA sufferers, pharmacological treatment such as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids and DMARD (Disease Modifying Antirheumatic Drugs) have an impact on drug side effects, namely gastrointestinal disorders that cause toxic effects on liver and kidney. The developed natural medicine treatment has been supported by several previous studies that provide anti-inflammatory benefits, namely, ginger (Zingiber Officinale Rosc.). Ginger (Zingiber Officinale Rosc.) The method used is descriptive. The purpose of this study was to determine the characteristics of respondents who suffer from rheumathoid arthritic therapy with essential ginger oil and resisted active movement. The results of the study showed that as many as 20 respondents who suffered from rheumatoid arthritis, based on their characteristics, the most were female, namely 16 people (80%, ages 60-75 years, as many as 15 people (75%), the most part of the joints experiencing rheumathoid arthritis. occurred in the knee as many as 9 people (45%), work history, at most not working as many as 8 people (40%), history of injury, there were most injuries as many as 12 people (60%)

Non-alcoholic fatty kidney disease (NAFKD): A novel disease that explains the etiology of hyperuricemia and gout in metabolic syndrome

Gout is the most common inflammatory arthritis in adults. It is causally associated with intraarticular deposition of monosodium urate crystals in hyperuricemia. The commonest pathogenesis is renal under-excretion of urate in metabolic syndrome. Despite being the commonest type, the exact etiology of hyperuricemia in metabolic syndrome remains unclear. Historically, common gout was found at increased rates in affluent men, earning its name the ‘disease of kings’. It is also rare in premenopausal women.The authors hypothesize that the etiology of common gout is a novel condition termed non-alcoholic fatty kidney disease (NAFKD). The hypothesis offers an explanation of the two prerequisites necessary for the development of NAFKD (that leads to hyperuricemia and gout) as follows: 1) sustained positive energy balance and 2) male sex hormone predominance state. The hypothesis presented herein could guide the prevention and early detection of hyperuricemia and support curative modalities.

Prevalence of rheumatoid arthritis among hospital workers in the north of Jordan: Preliminary report of a hospital-based cohort study

BackgroundRheumatoid arthritis (RA) is the most common autoimmune inflammatory arthritis in adults. Prevalence estimates of rheumatoid arthritis vary in the world. Occupational factors and geographical location might contribute to a higher risk of developing the disease, however the exact etiology remains unknown.The aim of our study was to estimate the prevalence of RA among hospital workers in the North of Jordan and to compare this prevalence with that in the general population. In addition to describing the characteristics of RA patients. MethodsThe study was performed in two stages; during the first stage a specially designed questionnaire was conducted by trained residents with 2569 hospital workers from 6 government hospitals to identify individuals with RA. Suspected individuals of having RA identified in stage one were invited and examined further by two rheumatologists for confirmation of the diagnosis. ResultsA total of 2569 employees were interviewed; among them 1240 (48.5%) were males and 1318 (51.5%) were females. The mean (SD) age was 34±(8.4) years. In the second stage the diagnosis of RA according to ACR criteria 1987 was confirmed in 8 individuals (2 males and 6 females). Male: Female (M: F) ratio was 1:3 with mean (SD) age 43.38 (7.52) years. The estimated prevalence of RA among hospital workers in the North of Jordan was 8/2569 = 0.00311, 31.1:10.000, 0.31%, (95% confidence interval, 9.6–52.7:10.000). ConclusionThe prevalence of RA among hospital workers in the North of Jordan is 0.31%, similar to that of other parts of Jordan and neighboring regions.

O14 Transitions in diagnosis and between services in juvenile idiopathic arthritis: living and learning

O14 Transitions in diagnosis and between services in juvenile idiopathic arthritis: living and learning

Change of diagnosis and diagnostic category in patients with juvenile idiopathic arthritis within 7 years of follow-up

At least 50% of pediatric patients with Juvenile Idiopathic Arthritis (JIA) will require continued fo llow-up in adult rheumatology. The present International League of Associations for Rheumatology (ILAR) classification, currently under revision, differs from its classification of inflammatory arthritis in adults. Category changes have been reported in 10.8% of patients during follow-up. To analyze JIA patients in follow-up for at least 7 years to detect diagnosis changes during transition to adult care, identifying factors of poor functional prognosis. Retrospective study based on medical records of JIA patients seen at the pediatric polyclinic of the Puerto Montt Hospital between 2005 and 2017, who were monitored for at least 7 years. Descriptive analysis was performed according to clinical variables: diagnostic category, evolution before diagnosis, clinical and serological activity, and evolution before starting drug therapy. We evaluated 18 pa tients, corresponding to 3 patients with persistent oligoarticular arthritis (OA), 1 with extended OA, 4 with polyarticular arthritis (PA) rheumatoid factor (RF) negative, 4 with PA RF positive, 5 with syste mic JIA, and 1 with psoriatic arthritis, all have had follow-up more than 7 years. 11 out of 18 patients transitioned to adult care. Three out of 11 patients changed diagnosis to Rheumatoid Arthritis (RA) plus another autoimmune disease such as Sjögren's Syndrome + Systemic Lupus Erythematosus, Immune thrombocytopenia, or unclassified autoimmune disease, and 5 out of 11 children changed ILAR category from OA to Juvenile Rheumatoid Arthritis, extended OA to PA RF negative, and 3 from Systemic arthritis to PA RF negative. Age of onset, polyarticular forms, delay in diagnosis, and the start of therapy were associated with sequelae and persistent inflammation. Eight of the eleven JIA patients who transitioned to adult care changed their diagnosis or presented other autoimmune diseases. Some factors of poor prognosis must improve.

Frequency Distribution of Bone Fractures in Rheumatoid Arthritis Patients: ACross-Sectional Study in Police Teaching Hospital, Khartoum 2019

Background: Rheumatoid arthritis (RA) is the most common form of inflammatory arthritis in adults. This study reveals the frequency distribution of bone fractures and the most frequent fracture sites in RA patients in Police teaching hospital, Sudan. Materials and method: A cross-sectional study was conducted in Khartoum, Sudan from September 2018 to September 2019. The questionnaire is in form of Multiple choice questions, Composed of Demographic information Regards their (age, sex, Occupation, and social habit), Information about the RA disease (duration, Risk factor, and investigation). Information concerning Bone fracture (if there is any fracture, site, how it detected). Statistical analysis was performed using SPSS, Version 22.0. (IBM, USA). Results: From patients diagnosed with RA, 25% had bone fractures out of 72 RA patients. A 72 rheumatic patients were involved in this crosssectional study, 11 of them (15.3%) were males and 61 (84.7%) were females. the mean of age was 50.6 years (48 years for male, 51years for female). The duration of rheumatoid in the majority of patients (36.1%) was falling between 2-5 years of diagnosis. The most common site of fracture is hip (36.9%) following by carpal bones (26.3%), then spinal vertebrae (10.5%). Conclusion: 25% of RA patients experienced bone fractures because of falling the most common site of bone fractures in RA patients is hip bone. Physicians should know the association between RA, bone fractures, and corticosteroid use to decrease bone fracture incidence. Also, investigations such as bone loss measurement should be done routinely to any RA patient.

Association between Gout, Urate-Lowering Therapy, and Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study.

Gout is the most prevalent inflammatory arthritis in adults. Although the link between gout and type 2 diabetes mellitus (T2DM) has been documented, our understanding of the association between urate-lowering therapy (ULT) among gout patients and T2DM development remains poor. We included 69,326 patients with new-onset gout in 2000-2011. Each case was matched randomly with 1 patient without gout during the study period, and 69,326 patients were recognized as the comparison cohort. A Cox proportional hazard regression model was used to analyze differences in the risk of T2DM development between patients with and without gout after considering related comorbidities. After adjusting for potential confounders, the case group had a higher risk of T2DM than the control cohort (adjusted hazard ratio (aHR) = 1.30, 95%confidence interval (CI) = 1.24-1.38; P < 0.001). Gout patients without appropriate ULT had significantly higher risk of T2DM development than the control cohort (aHR = 1.39; 95%CI = 1.30-1.48; P < 0.001). Among gout patients, those receiving ULT excluding probenecid (aHR = 0.80; 95%CI = 0.64-1.00), all had significantly lower risk of T2DM than gout patients without ULT (all aHR < 0.90; all P < 0.001). In this study, we found that gout increased the risk of T2DM; however, patients with any ULT exhibited a lower risk of T2DM than gout patients without any ULT (all aHR < 0.90, P < 0.001; excluding probenecid).

Rare Location and Clinical Presentation of Gout Disease: Distal Ulna Localized Gout Disease and Acute Gout Attack of the Wrist

Gout is one of the most common inflammatory arthritis in adults. This disorder is caused by the accumulation of monosodium urate crystals insoft tissues and joints because of the hyperuricemia. One of the lower extremity joint especially the first metatarsophalangeal joint is affectedby more than 75% of the gout attacks. In this study, we reported a rare presentation of gout disease, the acute gout attack of the wrist, in awoman, 72 years aged, who has not been diagnosed before. Gout which occurs with the involvement of the wrist is very rare and no other caseswith distal ulna localization have been reported according to our knowledge. We reported the first case of gout disease which started from distalulna. The patient was operated because the symptoms did not recover with conservative treatments.

Frequency distribution of bone fractures in rheumatoid arthritis patients: A cross-sectional study in police teaching hospital 2020

Background: Rheumatoid arthritis (RA) is the most common form of inflammatory arthritis in adults. This study reveals the frequency distribution of bone fractures and the most frequent fracture sites in RA patients in Police teaching hospital. Materials and Method: A cross-sectional study, a health facility-based was conducted in Khartoum, Sudan from January 2019 to January 2020. The questionnaire is in form of Multiple-choice questions, Composed of Demographic information Regards their (age, sex, Occupation, and social habit), Information about the RA disease (duration, Risk factor, and investigation). Information concerning Bone fracture (if there is any fracture, site, how it detected). Statistical analysis was performed using SPSS, Version 22.0. (IBM, USA). Results: From patients diagnosed with RA, 25% had bone fractures out of 72 RA patients. A 72 rheumatic patients were involved in this cross-sectional study, 11 of them (15.3%) were males and 61 (84.7%) were females. the mean of age was 50.6 years (48 years for male, 51years for female). The duration of rheumatoid in the majority of patients (36.1%) was falling between 2-5 years of diagnosis. The most common site of fracture is hip (36.9%) following by carpal bones (26.3%), then spinal vertebrae (10.5%), and talus bone (10.5%). Conclusion:25% of RA patients experienced bone fractures, the most common site of bone fractures in RA patients is hip bone following by carpal bones. Physicians should know the association between RA and bone fractures to decrease the bone fracture incidence. Also, investigations such as bone loss measurement should be done routinely to any patients with RA.

P391 Phenotyping inflammatory arthritis in adults with cystic fibrosis

P391 Phenotyping inflammatory arthritis in adults with cystic fibrosis