ABSTRACT
Anterior atlantoaxial subluxation is common in rheumatoid arthritis patients with involvement of the cervical spine. Sharp and Purser have described a test for the clinical assessment of this instability. We assessed the validity of the Sharp-Purser test in 123 outpatients with rheumatoid arthritis. Our findings indicate a predictive value of 85% and a specificity of 96%. The sensitivity was 88% when subluxation was greater than 4 mm. Our results show that the Sharp-Purser test is a useful clinical examination to diagnose atlantoaxial instability.
Subject(s)
Atlanto-Axial Joint , Joint Instability/diagnosis , Rheumatology/methods , Evaluation Studies as Topic , Humans , Joint Instability/diagnostic imaging , RadiographyABSTRACT
This double-blind multicenter study compares the effect of adding auranofin (AF) 3 mg bid or placebo to patients already taking nonsteroidal antiinflammatory drugs for rheumatoid arthritis. The 242 patients who completed 3 months of therapy demonstrated that the group receiving AF responded better than those receiving placebo. Of the 144 patients who completed 6 months coded medication, the efficacy in the AF group was superior to the placebo group in several parameters including a reduction in the number of painful or swollen joints, grip strength, dropout rate, and global efficacy as judged by the evaluating physician. A significant lowering of the Westergren erythrocyte sedimentation rate and immunoglobulin levels was noted in the AF treated patients. This study includes data summarizing the difference between both groups with respect to on-therapy conditions and toxicity.
Subject(s)
Arthritis, Rheumatoid/drug therapy , Aurothioglucose/analogs & derivatives , Gold/analogs & derivatives , Auranofin , Aurothioglucose/adverse effects , Aurothioglucose/therapeutic use , Clinical Trials as Topic , Female , Humans , Male , Middle Aged , PlacebosABSTRACT
We describe 3 patients whose findings fulfilled all the criteria for eosinophilic fasciitis. Unexpectedly, all 3 were found to have thyroid disease: 2 Hashimoto's disease and 1 Grave's disease. One patient also developed multiple subcutaneous nodules of a rheumatoid type. All have been followed for at least 3 yr and shown marked clinical improvement. Corticosteroids were employed in only 1 case.
