The validity and reliability of the Moroccan version of the Revised Fibromyalgia Impact Questionnaire.

The Revised Fibromyalgia Impact Questionnaire (FIQ-R) is an updated version of the FIQ attempts to address the limitations of the Fibromyalgia Impact Questionnaire (FIQ). As there is no Moroccan version of the FIQ-R available, we aimed to investigate the validity and reliability of a Moroccan translation of the FIQR in Moroccan fibromyalgia (FM) patients. After translating the FIQR into Moroccan, it was administered to 80 patients with FM. All of the patients filled out the questionnaire together with Arabic version of short form-36 (SF-36). The tender-point count was calculated from tender points identified by thumb palpation. Three days later, FM patients filled out the Moroccan FIQR at their second visit. The test-retest reliability of the Moroccan FIQR questions ranged from 0.72 to 0.87. The test and retest reliability of total FIQR score was 0.84. Cronbach's alpha was 0.91 for FIQR visit 1 (the first assessment) and 0.92 for FIQR visit 2 (the second assessment), indicating acceptable levels of internal consistency for both assessments. Significant correlations for construct validity were obtained between the Moroccan FIQ-R total and domain scores and the subscales of the SF-36 (FIQR total versus SF-36 physical component score and mental component score were r = -0.69, P < 0.01 and r = -0.56, P < 0.01, respectively). The Moroccan FIQ-R showed adequate reliability and validity. This instrument can be used in the clinical evaluation of Moroccan and Arabic-speaking patients with FM.

A comparison of ultrasound and clinical examination in the detection of flexor tenosynovitis in early arthritis.

BACKGROUND: Tenosynovitis is widely accepted to be common in rheumatoid arthritis (RA) and postulated to be the first manifestation of RA, but its true prevalence in early disease and in particular the hand has not been firmly established. The aims of this study were first to investigate the frequency and distribution of finger flexor tenosynovitis using ultrasound in early arthritis, second to compare clinical examination with ultrasound (US) using the latter as the gold standard. METHODS: 33 consecutive patients who had who were initially diagnosed with polyarthritis and suspected of polyarthritis and clinical suspicion of inflammatory arthritis of the hands and wrists were assessed during consecutive, routine presentations to the rheumatology outpatient clinic. We scanned a total of 165 finger tendons and subsequent comparisons were made using clinical examination. RESULTS: Flexor tenosynovitis was found in 17 patients (51.5%) on ultrasound compared with 16 (48.4%) of all patients on clinical examination. Most commonly damaged joint involved on US was the second finger followed by the third, fifth, and fourth. Both modalities demonstrated more pathology on the second and third metacarpophalangeal (MCP) compared with the fourth and fifth MCP. A joint-by-joint comparison of US and clinical examination demonstrated that although the sensitivity, specificities and positive predictive values of clinical examination were relatively high, negative predictive value of clinical examination was low (0.23). CONCLUSIONS: Our study suggest that clinical examination can be a valuable tool for detecting flexor disease in view of its high specificity and positive predictive values, but a negative clinical examination does not exclude inflammation and an US should be considered. Further work is recommended to standardize definitions and image acquisition for peritendinous inflammation for ultrasound.

Translation, adaptation and validation of the Moroccan version of the Quebec Back Pain Disability Scale.

This study aims to translate and cross-culturally adapt the Moroccan version of the Quebec Back Pain Disability Scale (QDS) and to investigate its reliability and validity in Moroccan patients with low back pain (LBP). The translation and cross-cultural adaptation of the QDS were developed in agreement with published guidelines. The QDS was translated by use of the forward and backward translation procedure. After pretest, it was validated in 64 Moroccan patients with LBP. The QDS was recorded twice, at baseline visit and 72 h later. Reproducibility was evaluated using intraclass correlation coefficient (ICC) and Bland and Altman method. Internal consistency was measured by Cronbach α coefficient. Ceiling and floor effects were assessed. Validity was measured by correlating the scores of the Moroccan QDS with visual analogue scale (VAS) for Pain, Disability VAS, Schober test, fingertip-floor measurement and the Moroccan version of the Roland Morris Disability Questionnaire (RMDQ) by means of the Spearman rank correlation coefficient. Association with gender and education level was also studied. Reliability was excellent with an ICC (type 2.1) of 0.959 (CI 95%: 0.934-0.975). The internal consistency was high with a Cronbach α of 0.979. The Bland and Altman method showed homogenous distribution of the differences, with no systematic trend. There were no floor or ceiling effects. The correlation between QDS and RMDQ was very good (r = 0.664; p ≤ 0.001). There was no correlation between QDS and the other variables. Accordingly, the Moroccan version of QDS has good reproducibility, internal consistency and validity for the assessment of disability in Moroccan-speaking patients with LBP.