{"title":"Dépistage de l’ostéoporose avant et après une fracture : état des lieux et pistes d’amélioration","authors":"Pascale Guillot","doi":"10.1016/j.monrhu.2022.05.004","DOIUrl":"10.1016/j.monrhu.2022.05.004","url":null,"abstract":"<div><p>The number of fractures related to osteoporosis is expected to increase in the next years because of the aging of the population and an increase in the number of osteoporotic elderly patients at high risk of falls. Few patients with osteoporosis, mostly women over 60, benefit from screening, even after fracture despite recent recommendations (imminent risk for fracture, severe fracture). We needed the involvement of Health Authorities to take care of fractured patients (Fracture Liaison Services, opportunistic osteoporosis screening) but also before fracture (systematic screening of women over 60).</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88382409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pourquoi et comment organiser le dépistage et la prévention des complications des rhumatismes inflammatoires chroniques : Intérêt des revues systématiques initiales et périodiques","authors":"Maxime Dougados","doi":"10.1016/j.monrhu.2022.07.001","DOIUrl":"10.1016/j.monrhu.2022.07.001","url":null,"abstract":"<div><p>Patients suffering from chronic inflammatory rheumatic diseases (whether rheumatoid arthritis, spondyloarthritis, connective tissue disease but also microcrystalline arthropathy or even polyarthrosis) should be able to benefit from standardized holistic care as soon as the diagnosis of chronic inflammatory rheumatic disease is done then periodically. This management (also called « systematic review ») must include a) an ov erall assessment of the disease (certainty of the diagnosis, activity, severity, potential severity and finally the notion of refractory disease or not) b) learning a self-assessment disease activity via composite indices such as the DAS-28 for rheumatoid arthritis or the ASDAS for spondyloarthritis c) an assessment of adherence to treatment d) prevention of the main comorbidities e) information/education about the disease and its treatments f) information about the different areas that could impact the patient's life (diet, sexuality, pregnancy, social care, etc..). Although our health authorities have put in place the means to support these systematic reviews, it is necessary that the treating rheumatologists are convinced of their interest to ensure their success.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87978630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Peut-on prédire la polyarthrite rhumatoïde ?","authors":"Benoît Thomas P. Gilbert, Céline Lamacchia","doi":"10.1016/j.monrhu.2022.06.001","DOIUrl":"10.1016/j.monrhu.2022.06.001","url":null,"abstract":"<div><p>Various scores attempt to predict the development of RA. In particular, EULAR proposes a simple rule to identify new onset arthralgias suspicious of progression to RA. However, serological tests are necessary to ensure acceptable specificity. In patients with clinical arthritis, reliable predictive criteria for progression to RA have also been identified. Overall, the validity of the available scores is still debated. Such scores limitedly take into account interactions between risk factors in specific subpopulations. New technologies could help to overcome these limitations, but we need databases containing sufficient numbers of RA and pre-RA patients, including pre-diagnostic follow-up. Today, existing predictive rules do not seem to compete significantly with expert opinions.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84067802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janvier Murayire, Xavier Chevalier, Florent Eymard
{"title":"Pouvons-nous prévenir l’arthrose ?","authors":"Janvier Murayire, Xavier Chevalier, Florent Eymard","doi":"10.1016/j.monrhu.2022.05.002","DOIUrl":"10.1016/j.monrhu.2022.05.002","url":null,"abstract":"<div><p>Considering the high prevalence and imposing social-economic burden of osteoarthritis, its prevention prevails as the backbone of the management. The prevention hinders the onset (primary prevention) and slows down the progression (secondary and tertiary prevention) of the disease. It includes pharmacological and non-pharmacological treatments and clinical, biological and/or radiological screening techniques. We have chosen to review available primary and secondary/tertiary preventives measures for knee and hip osteoarthritis. The primary prevention will address mainly modifiable risk factors including the choice and the intensity of the physical activity, traumas, overweight, metabolic abnormalities, misalignment, and dysplasia. Concerning the secondary and/or tertiary prevention, we will discuss early screening techniques including diagnostic imaging and biomarkers, non-pharmacological therapeutics as weight loss, physical activity, diet or braces and pharmacological therapeutics as “slow acting parenteral anti-osteoarthritis treatments”, intraarticular injections, and surgeries. One must bear in mind that to date, no single treatment measure has proven a structural efficacy against established osteoarthritis hence the tremendous role of primary prevention in osteoarthritis management.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72850233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vers une médecine plus préventive en rhumatologie","authors":"Claire Daien","doi":"10.1016/j.monrhu.2022.09.001","DOIUrl":"10.1016/j.monrhu.2022.09.001","url":null,"abstract":"","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75317807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dépistage et prévention des affections rhumatologiques en milieu de travail","authors":"Audrey Petit , Yves Roquelaure","doi":"10.1016/j.monrhu.2022.07.006","DOIUrl":"10.1016/j.monrhu.2022.07.006","url":null,"abstract":"<div><p>Musculoskeletal disorders (MSDs) are the leading cause of occupational disease in France and in Europe and are responsible for serious economic and social consequences, at individual, company and country level. MSDs are of multifactorial origin, combining individual susceptibility factors and a range of biomechanical, psychosocial, organizational and managerial causes of the workplace. The prevention of MSDs requires a global and integrated approach, favoring the reduction of risks at source through action in the workplace, screening and early management of patient-workers suffering from these disorders and, if necessary, maintenance employed. Their management is based on an overall assessment of the clinical and socioprofessional situation. The coordination of medical, rehabilitative and professional care is a key element of professional prognosis and job retention.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78570460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gaetane Nocturne , Marjolaine Gosset , Antoine Rousseau
{"title":"Prise en charge de la sécheresse buccale et oculaire","authors":"Gaetane Nocturne , Marjolaine Gosset , Antoine Rousseau","doi":"10.1016/j.monrhu.2022.03.004","DOIUrl":"10.1016/j.monrhu.2022.03.004","url":null,"abstract":"<div><p>Sjögren's disease or primary Sjögren's syndrome (pSS) is characterized by the association of a symptomatic triad (dryness, pain and fatigue) with various systemic manifestations. While systemic involvement affects about 30% of patients, sicca, mainly ocular and oral, is present in almost all patients. This symptom causes high burden of the disease and a marked deterioration in quality of life. It should not be neglected in the management of pSS patients. The purpose of this update is to provide a review of the mechanisms that cause dry syndrome in pSS, to outline the potential consequences of this symptom, and to give practical tools to guide the management of our pSS patients. Finally, this article reviews the impact of targeted therapies in development in pSS on dryness.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75930675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physiopathologie du Sjögren primitif : une épithélite auto-immune","authors":"Emiko Desvaux , Jacques-Olivier Pers","doi":"10.1016/j.monrhu.2022.02.004","DOIUrl":"10.1016/j.monrhu.2022.02.004","url":null,"abstract":"<div><p>Primary Gougerot–Sjögren syndrome (SSp) is characterized by an autoimmune epithelitis associated with chronic inflammation of the exocrine glands. Alterations of and extraglandular functions of SSp is associated with lymphocytic infiltrates that invade the epithelial structures of affected organs. Within epithelial tissue, the expression of major class II histocompatibility complexes (MHC II) and costimulatory molecules by epithelial cells acting as non-professional antigen presenting cells, lead to the activation of T and B lymphocytes through multiple cellular crosstalks. Although the pathogenetic pathways underlying SSp have not yet been elucidated, it is established that glandular epithelial cells are central regulators of the local autoimmune response.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81625086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jean-Jacques Dubost, Marion Couderc, Anne Tournadre
{"title":"Maladie de Sjögren, syndrome asthénie polyalgie sécheresse (SAPS) et fibromyalgie","authors":"Jean-Jacques Dubost, Marion Couderc, Anne Tournadre","doi":"10.1016/j.monrhu.2022.04.002","DOIUrl":"10.1016/j.monrhu.2022.04.002","url":null,"abstract":"<div><p>The combination of dry eyes and mouth, fatigue and pain in the limbs suggests Sjögren's syndrome, a systemic autoimmune disease. The association also characterizes the sicca, asthenia, polyalgia syndrome (SAPS), which is considered to be an equivalent of fibromyalgia and is common in fibromyalgia. These 2 entities have a high prevalence unlike Sjögren's syndrome. The distinction between these pathologies is made by applying the ACR/EULAR criteria for Sjögren's syndrome which require the presence of anti-SSA or a focus score<!--> <!-->≥<!--> <!-->1 on the labial salivary gland biopsy (LSGB). In the absence of anti-SSA and when the diagnostic probability is low, the salivary gland ultrasonography, which shows a high negative predictive value, could be an intermediate step before deciding on the LSGB, which is a little more aggressive. About 20% of patients with Sjogren's syndrome have concomitant fibromyalgia. These patients have a higher ESSPRI score (EULAR Sjögren's Syndrome Patient Related Index) (assessment by a VAS of pain, fatigue and dryness), while the ESSDAI score (EULAR Sjögren’ Syndrome Disease Activity Index) which measures systemic impairment, is no different from patients without fibromyalgia. In this population, unlike primary fibromyalgia, agreement between the fibromyalgia criteria is not good. The symptoms of fibromyalgia and Sjogren’ syndrome are very similar, and fibromyalgia criteria have difficulty discriminating between them.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85352094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Traitement des atteintes systémiques de la maladie de Sjögren","authors":"Véronique Le Guern, Gaelle Becel","doi":"10.1016/j.monrhu.2022.04.004","DOIUrl":"10.1016/j.monrhu.2022.04.004","url":null,"abstract":"<div><p>Primary Sjögren's syndrome (SSp) is a progressive autoimmune disease characterized by a sicca syndrome but also by the occurrence of systemic manifestations. These manifestations, present in 30–40 % of patients, are varied, can involve many organs, and coexist with each other. They are of highly variable severity, and justify an adaptation of the therapeutic management which can range from a simple symptomatic treatment, to the use of immunosuppressants, biotherapies, combined therapies. The ESSDAI activity score makes it possible, in each organ system, to assess the severity and to stratify the management of these systemic disorders. Due to the wide variety of systemic damage encountered, it is important to offer multidisciplinary care. Despite active research and numerous therapeutic trials in progress or to come, no molecule has obtain agreement for the treatment of pSS. Consequently, the various therapeutic strategies that will be discussed here are essentially based on retrospective studies and expert opinions, and based and recent published recommendations.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83095131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}