Methotrexate in chronic-recurrent calcium pyrophosphate deposition disease: no significant effect in a randomized crossover trial.

Introduction: Calcium pyrophosphate deposition (CPPD) may cause severe arthropathy, major joint destruction and treatment options are limited. The aim of this study was to test the therapeutic efficacy of methotrexate (MTX) in chronic or recurrent CPPD arthropathy.

Methods: Patients with CPPD arthropathy were randomized to receive either weekly subcutaneous injections of 15 mg/week of MTX or placebo (PBO) for three months, in a double-blind, crossover randomized controlled trial.

[Erosive hand osteoarthritis].

Erosive hand osteoarthritis is common and debilitating. Diagnosis is based on the presence of bone erosions which can appear late. Ultrasonography allows earlier diagnosis.

Pathogenic role of basic calcium phosphate crystals in destructive arthropathies.

Background: basic calcium phosphate (BCP) crystals are commonly found in osteoarthritis (OA) and are associated with cartilage destruction. BCP crystals induce in vitro catabolic responses with the production of metalloproteases and inflammatory cytokines such as interleukin-1 (IL-1). In vivo, IL-1 production induced by BCP crystals is both dependant and independent of NLRP3 inflammasome.

[Liquid lipid crystals-induced arthritis].

Liquid lipid crystals-induced arthritis crystals are a frequent cause of arthritis. They are disclosed by the microscopic examination of the synovial fluid. They are usually made of monosodium urate, calcium pyrophosphate or apatite.

[The humeroradial impingement].

Lateral pain of the elbow is frequently reported. Impingement of the humeroradial fold or a synovial fringe is a seldom evoked cause, sometimes ignored. Nonetheless, this etiology should be remembered in young adults performing sport activities and in heavy workers.

[Clinical presentation imaging and treatment of digital osteoarthritis].

Digital osteoarthritis relates to primarily the distal interphalangeal (DIP) and first carpometacarpal (CMC-I) joints. Heberden's nodes often accompany osteoarthritis of the DIP joints. Osteoarthritis of the PIP joints can be more painful and more inflammatory.

[Evaluation of the adhesion to the EULAR and OARSI recommendations for the treatment of knee and hip osteoarthritis in current practice].

Recommendations for the treatment of hip and knee osteoarthritis (OA) have been recently published by international scientific societies (EULAR, OARSI). The aim of this study was to evaluate, in real life, the acceptance of these recommendations in the two districts of the Neuchâtel mountains. In March 2008, a questionnaire was sent to all the general practitioners (GP = 23), internists (IM = 22), orthopedic surgeons (ORTHO = 8) and rheumatologists (RHEUMATO = 3) of the districts of Le Locle and La Chaux-de-Fonds (population of 55000 people).

[Tophaceous calcium pyrophosphate dihydrate deposits in a finger].

Calcium pyrophosphate dihydrate (CPPD) deposits are frequently observed in joint tissues. They can also occur in other tissues and present as a tophus. Contrarily to gout, a CPPD tophus is exceptionally localized in a finger.

[Dry cough, chest pain and difficult breathing in a patient with rheumatoid arthritis].

Pulmonary involvement is the most frequent extra-articular manifestation of rheumatoid arthritis. The occurrence of a chronic hydro-pneumo-thorax associated with pulmonary nodules is rare. Cavitation of the most superficial nodules and their rupture into the pleural cavity are most likely involved in this complication.

Miller-Fisher syndrome in a patient with rheumatoid arthritis treated with adalimumab.

Adalimumab is a frequently prescribed TNFalpha inhibitor for treatment of rheumatoid arthritis. We report on a patient who probably developed a Miller-Fisher syndrome after the second injection of adalimumab.

[Patellar hypertrophy: rare abnormality associated with a multiple epiphyseal dysplasia].

Multiple epiphyseal dysplasia is a genotypic chondrodystrophy characterized by an abnormal shape of numerous epiphyses. Diagnosis is usually made during childhood on an abnormal gait and a reduction of joint mobility associated with radiological changes of the ossification centres. This observation reports on a woman who only consulted at adulthood.

[Rotator cuff tear of the hip].

We report the observations of two women with a recurrent periarthritis of the hip complicated by a spontaneous rupture of the tendons of the gluteus medius and minimus. These patients usually complain from an acute lateral hip pain and show a Trendelenburg gait. When the rupture is complete, clinical evaluation reveals a drop of the pelvis on the non-stance side and resisted rotation starting from the extreme external rotation position is weak.

[Intensification of a diffuse chronic pain syndrome by the introduction of an aromatase inhibitor].

A case of a menopausal woman known for a chronic diffuse pain syndrome and breast cancer positive for estrogen receptors is presented. She developed an increase of her diffuse pain syndrome and joint aches after the introduction of an aromatase inhibitor. Soreness quickly improved after the interruption of the drug.