ABSTRACT
OBJECTIVE: To determine the relationship between frequent intraarticular corticosteroid injection and subsequent joint replacement surgery. METHODS: A 1987 database of patients with rheumatic diseases was reviewed to find patients with rheumatoid arthritis (RA) who had received 4 or more intraarticular injections in an asymmetric pattern in a single year. RESULTS: A subset of 13 patients with an average of 7.4 years of followup was established as the cohort of a 5 year prospective study. In this highly selected cohort of patients with RA in a university practice who received 1622 injections, joint replacement surgery was not significantly more common in the heavily injected joints. CONCLUSIONS: A strategy of frequent intraarticular steroid injection does not greatly increase, through added risk of joint replacement, the risk inherent in continued disease activity for patients with established RA. Frequent corticosteroid injection may offer some chondroprotection when the alternative is continuous disease activity.
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , Arthritis, Rheumatoid/drug therapy , Joint Prosthesis , Osteoarthritis/surgery , Humans , Injections, Intra-Articular , Osteoarthritis/chemically induced , Retrospective StudiesSubject(s)
Complement C8/deficiency , Meningitis, Meningococcal/complications , Adult , Female , Humans , RecurrenceABSTRACT
A middle aged male developed recurrent episodic inflammatory effusions of the right knee associated with radiographic findings consistent with osteochondromatosis. Calcium pyrophosphate dihydrate (CPPD) crystals were identified by polarized light and electron microscopy, although chondrocalcinosis was not demonstrated radiographically in this joint or any other locations. Analysis of noninflammatory fluid from the left knee demonstrated apatite crystals. The unique association of CPPD crystals and synovial osteochondromatosis without evidence of chondrocalcinosis and the relationship of these 2 entities is discussed.
Subject(s)
Chondrocalcinosis/complications , Chondroma/complications , Synovial Membrane , Calcium Pyrophosphate/analysis , Chondrocalcinosis/pathology , Chondroma/diagnostic imaging , Humans , Male , Middle Aged , Radiography , Synovial Fluid/analysisSubject(s)
Intervertebral Disc/pathology , Spondylitis, Ankylosing/complications , Humans , Male , Middle AgedABSTRACT
A case of definite ankylosing spondylitis (AS), classical rheumatoid arthritis (RA) and membranous nephropathy is presented. Concurrent presence of the HLA-B27 and HLA-DR4 antigens was demonstrated. The association of AS and RA as well as RA and membranous nephropathy are discussed and the literature reviewed.
