Knee osteoarthritis (OA) is a disabling joint disease that results in degeneration of the joint cartilage. Many studies demonstrate the risk factors and complications of knee osteoarthritis, but how physical activity impacts the osteoarthritis severity needs to be studied. The study aimed to assess the impact and association of physical activity level with the severity of knee osteoarthritis among patients attending a single center in the Aseer region, southwest Saudi Arabia. An analytical cross-sectional study was conducted targeting all patients clinically diagnosed with knee osteoarthritis in the Aseer region from June 2021 to September 2021. Data was collected using a pre-structured online questionnaire. The questionnaire included patients' socio-demographic data and clinical data on knee osteoarthritis. The level of physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). The severity of knee osteoarthritis was assessed using the index of severity for osteoarthritis of the knee. Out of 473 patients clinically diagnosed with knee OA, only 145 patients met our inclusion criteria. Patients' ages ranged from 35 years to 71 years, with a mean age of 44.3 (±12.9) years. A total of 122 (84.1%) patients were females. Sixty-five (44.8%) patients complained of knee OA for less than two years, 46 (31.7%) for two to five years, and 34 (23.4%) were diagnosed for more than five years. A total of 96 (66.2%) had a low level of physical activity, 32 (22.1%) had a moderate level of physical activity, while 17 (11.7%) had a high level of physical activity. Thirty-eight (26.2%) cases complained of extremely severe knee OA, 37 (25.5%) had very severe knee OA, 28 (19.3%) complained of severe knee OA, 36 (24.9%) had mild to moderate knee OA, while six (4.1%) had minimal knee OA. There was a significant beneficial effect of physical activity on the severity of knee OA. The study revealed that physical activity, especially at high levels, was associated with lower knee OA severity which means a beneficial effect. Most of the patients included in the study had severe to extremely severe knee OA with low physical activity levels.

Behçet's disease (BD) is a multisystem disorder with various clinical presentations. Herein, we present a lethal complication associated with pulmonary artery aneurysm due to BD, resulting in massive hemoptysis that was controlled using endobronchial balloon lung isolation.

Adult-onset Still’s disease (AOSD) is an inflammatory disorder characterized by fever, arthritis, and a transient skin rash. It is a rare condition characterized by inflammatory multisystem changes of unknown cause. A 35-year-old woman was admitted to rheumatology department of tertiary care hospital complaining of painful wrist and skin rash as well as fever, generalized lymphadenopathy, weight loss, and fatigue. The early diagnosis of AOSD was confirmed by clinical history, examination, and laboratory tests, as well as a confirmatory skin biopsy with typical histopathological features, namely, upper epidermal dyskeratosis and dermal inflammatory neutrophilic infiltration. The patient’s condition was treated with steroids and NSAIDs, to which she responded well, and on follow-up, her symptoms regressed along with improvement in biochemical parameters. The authors suggest that skin biopsy and confirmation of histopathological diagnosis of AOSD are useful in the diagnosis and proper management of AOSD patients in cases with clinical suspicion of AOSD.

A BSTRACT: Background: Osteoporosis is a chronic skeletal disorder characterized by reduced bone strength and increased risk of fractures. It is a significant public health concern worldwide, particularly among the elderly population. Objectives: This study aimed to assess the clinical pattern and complications of osteoporosis in Khamis Mushait, Southern of Saudi Arabia. Methodology: A cross-sectional study with record-based data extraction was used, including clinically diagnosed cases with osteoporosis achieving their clinical pattern and associated complications. Results: A study of 92 osteoporotic patients aged 37–100 years found that the majority were females, with risk factors including gender, age, steroid use, and rheumatoid arthritis (RA) diagnosis. Half of the cases presented with bone pain, with 88% having no complications. Serum vitamin D and calcium levels varied between low and normal levels. Conclusions: The study found that most osteoporosis cases are females over 60 years old, with aging, female gender steroid use, and RA as risk factors. Most cases present with bone pain, but some have low vitamin D and calcium levels.

Fatigue is a prevalent and disabling feature of rheumatoid arthritis (RA) that interferes with everyday tasks and overall quality of life. Evidence on how RA-related fatigue affects activities of daily living (ADL) in Middle Eastern, and particularly Saudi Arabian, populations is sparse. This study aimed to quantify fatigue severity in patients with RA seen at a tertiary center in the Aseer region and examine its relationship with disease activity and ADL, using the Bristol RA Fatigue Multidimensional Questionnaire (BRAF-MDQ). We carried out a single-center, cross-sectional study with prospective data collection at the rheumatology outpatient clinics of Aseer Central Hospital, Saudi Arabia, between March and December 2024. Adults aged 16 years or older with RA, classified according to the 2010 American College of Rheumatology–European Alliance of Associations for Rheumatology criteria, were enrolled consecutively by convenience sampling. Fatigue was rated with the Arabic version of the BRAF-MDQ; disease activity was scored with the Disease Activity Score in 28 joints using C-reactive protein (DAS28-CRP); and functional status was captured with a validated 12-item ADL score. Independent-samples t -tests, Spearman rank correlation, and multivariable linear regression were performed in International Business Machines Statistical Package for the Social Sciences Statistics version 22 (IBM Corp.). A total of 140 patients were analyzed (82.1% women; mean age 47 years). Women had higher global BRAF-MDQ scores than men (46.1 vs 32.2; P < .001), with the difference driven mainly by the physical and emotional subscales. Patients in the high-fatigue group showed substantially greater ADL impairment than those in the low-fatigue group (10.64 ± 7.45 vs 3.42 ± 2.54; P < .001). BRAF-MDQ scores correlated strongly with both DAS28-CRP ( ρ = 0.932–0.989) and ADL ( ρ = 0.879–0.992). In the multivariable model, DAS28-CRP ( β = 0.055; 95% confidence interval, 0.040–0.070) and ADL ( β = 0.042; 95% confidence interval, 0.030–0.054) were each independently and positively associated with global fatigue. In this Saudi cohort, fatigue in RA was widespread and tracked closely with both disease activity and impairment of daily activities, with women reporting heavier burden in unadjusted comparisons. Routine fatigue assessment, together with evidence-based non-pharmacological strategies, should be embedded into the ambulatory care of patients with RA.