RESUMO
Chondrocalcinosis and Menicial injuries are both common findings on knee X ray and MRI [magnetic resonance Imaging] respectively. When both findings coexist in the setting of a painful knee effusion, they can lead to a diagnostic dilemma which is not always easy to sort out. This case report describes such a situation
RESUMO
OBJECTIVE: To assess the role of Disodium pamidronate [ 3-amino-1-hydroxypropylidine-1,1-bisphosphonate] in the management of Rheumatoid Arthritis
STUDY DESIGN: A prospective, open, randomized, observational, dose response comparasion [30 mg vs 15 mg of Disodium Pamidronate] study done in the medical department of Cantonment General Hospital Rawalpindi over a three month period
PATIENTS AND METHODS: 16 patients of both genders with rheumatoid arthritis were divided into two groups of 8 each. [Designated A and B.].All patients had established Rhuematoid Arthritis according to 1987 American Rheumatology association revised criteria for the diagnosis of Rheumatoid Arthritis. Each group was randomly allocated to receive a single infusion of Disodium Pamidronate of either 15 [group A] or 30 mg [group B] . A number of parameters of disease activity were recorded [Grip strength [dominant hand; mean of three readings],Ritchie articular index, and early morning stiffness among others]. All patients were admitted and directly observed initially
RESULTS: Group A: Was given 15 mg Pamidronate infusion.Two [2] patients [25 %] showed improvement in clinical parameters and biochemical parameters. 6 patients showed biochemical improvement alone
Group B: Was given 30mg Pamidronate infusion. Five [5] patients [70%] showed rapid clinical and biochemical improvement which was relatively sustained for 1-3 months. All the 8 patients showed biochemical improvement. A transient flu like illness observed in one patient only however he was a responder
CONCLUSIONS: 30mg of single Disodium Pamidronate infusion in an efficacious and rapidly acting management strategy in the therapy of active rheumatoid arthritis. The response is dose related