The degree of radiographic abnormalities and postural instability in patients with knee osteoarthritis.

Aim: to determine the degree of radiographic abnormalities based on Kellgren-Lawrence criteria, to determine posturography features in patients with knee OA. Methods: ninety nine subjects were recruited by consecutive sampling at the outpatient clinic of Internal Medicine in Cipto Mangunkusumo Hospital. History taking and physical examination including rheumatology examination were conducted, followed by knee radiographic examination in weight bearing and 30 degree skyline position. A cross sectional design was performed to evaluate the variable results for degree of radiolographic abnormalites and posturography results. Results: the subjects were 79.8% women and 20.2% men, mostly >/= 60 year-old (78.8%), with low education 76.8%, BMI >/= 23 74.7%, mean value of active VAS was 5.4, mean value of passive VAS 2.8. Mild radiographic abnormality was found in 77.8% subjects, and the others were severe, i.e. 22.2%. There were increase in length of postural sway, increase of postural sway velocity, and increase in area of postural sway in patients with knee OA compared with normal subjects with 40-60 years old. Conclusion: there is an increase in nearly all variables of posturography in patients with knee OA.

Cerebral thrombosis in systemic lupus erythematosus with the antibody antiphospholipid syndrome.

Systemic lupus erythematosus (SLE) has numerous manifestations. Haematology is the common system influenced by the disease. The antibody antiphospholipid syndrome, secondary hematology disorder in SLE, is related to high incidence of thrombosis. The thrombosis events like myocardial infarction and stroke are high in mortality. We reported a-36-year old woman treated for lung tuberculosis (TB) with secondary infection, nephritis lupus, and pancytopenia. The general condition has improved and the patient was planned to discharge while she suddenly fell down, unconscious and had seizure. The CT-scan showed an area of hypodensity on the left thalamus. Haematology results showed high level of fibrinogen and D-dimer as the signs of thrombosis. The anticardiolipin antibody was intermediately positive for IgG and IgM, but lupus anticoagulan was weakly positive. The serial test within 2 months still showed positive IgG. The patient received supportive treatment, heparinization, neurotropic drugs and anticonvulsant. She was discharged in good condition while continuing oral anticoagulant to prevent recurrent seizure.