Malar rash in a patient with Reiter's syndrome--a clue for the diagnosis of human immunodeficiency virus infection.

We describe a man who presented with Reiter's syndrome and a new prominent malar rash. The malar rash was the clue for the early diagnosis of human immunodeficiency virus (HIV) infection in this patient. A high index of suspicion for the diagnosis of HIV infection is required in patients with Reiter's syndrome presenting with unusual clinical manifestations.

Septic bursitis in human immunodeficiency virus infection.

Septic bursitis is a well described entity in immunocompromised patients. Common factors contributing to an immunocompromised state are alcoholism and corticosteroid therapy. We describe 2 patients with Staphylococcus aureus olecranon bursitis with evidence of human immunodeficiency virus (HIV) infection and no other contributing factors to immunodeficiency.

Non-steroidal anti-inflammatory drugs (NSAIDs) cause gastrointestinal intolerance and major bleeding--or do they?

Non-steroidal anti-inflammatory drugs are a mainstay of treatment of the inflammatory arthritides. Unfortunately, they are often associated with dyspepsia, and this troublesome side-effect is a limitation to their chronic use by many patients. The use of enteric-coated preparations has improved the ability of this large group of patients to use these drugs.

Coexistent septic and crystal arthritis. Report of four cases and literature review.

The coexistence of acute crystal induced synovitis and septic arthritis is an uncommonly reported occurrence. Twenty-two cases have been reported. Four additional patients are described and possible pathogenic mechanisms discussed.

The frequency of malignant neoplasms in patients with polymyositis-dermatomyositis. A controlled study.

Seventy-one patients with polymyositis-dermatomyositis (PM/DM) admitted to the Wellesley Hospital Rheumatic Disease Unit (RDU) in Toronto between 1965 and 1980 were followed up to 1981. The frequencies of malignant neoplasms occurring prior to or concurrent with initial RDU admission were compared, using case-control methods, with age- and sex-matched control groups with a diagnosis of any non-PM/DM rheumatic disease (rheumatic disease controls) or osteoarthritis, fibrositis, or fracture (noninflammatory musculoskeletal controls). In a cohort analysis, the incidence of malignant neoplasm subsequent to initial RDU admission in patients with PM/DM was compared with the expected incidence in the Canadian population.

Hypertrophic pulmonary osteoarthropathy in four patients with interstitial pulmonary disease.

The association between digital clubbing and idiopathic pulmonary fibrosis has been well established; however, the simultaneous occurrence of hypertrophic pulmonary osteoarthropathy and interstitial fibrosis, in the absence of neoplastic disease, has only been described in two case reports and was not mentioned in any of 336 patients described in several recent reviews. Among 70 patients referred for investigation of pulmonary infiltrates, four were found to have hypertrophic pulmonary osteoarthropathy associated with interstitial pulmonary disease, in the absence of malignant disease. We conclude that the use of bone scans and roentgenographic examination of the extremities may draw attention to an association between hypertrophic pulmonary osteoarthropathy and idiopathic pulmonary fibrosis.

Biomechanical and biochemical properties of dog cartilage in experimentally induced osteoarthritis.

The finding of other investigators that increased water content is often associated with signs of a torn collagen network in human osteoarthritic (OA) cartilage led to this study. In the Pond-Nuki model of post-traumatic OA experimental but not control femoral condylar cartilage showed evidence of breakdown and stiffening of collagen network as assessed by measurement of swelling properties and indentation behaviour respectively. These changes in the unstable knees occurred despite lack of erosion of that surface cartilage ascertained from carbon black mapping and history.

Fatal bronchiolitis obliterans associated with chrysotherapy.

We describe a patient who developed fatal bronchiolitis obliterans following gold therapy and review the relationship between rheumatoid arthritis and bronchiolitis.

Comparison of phosphohydrolase activities from articular cartilage in calcium pyrophosphate deposition disease and primary osteoarthritis.

One abnormality in calcium pyrophosphate deposition disease (CPDD) which fosters consistently high synovial fluid pyrophosphate ion (PPi) and large accumulations of calcium pyrophosphate dihydrate crystals (Ca pyrophosphate) might be an aberration in chondrocytes involving elaboration of PPi and failure of its hydrolysis within cartilage matrix. Exploration of this hypothesis required further information on the phosphohydrolases in relevant human articular cartilages. Triton X-100 extracts of whole homogenized cartilage from 18 patients with primary osteoarthritis (OA), 10 patients with CPDD and secondary OA, as well as 6 "normal" subjects were partially purified by DE-52 chromatography and eluates studied for phosphohydrolase activity in a variety of substrates, inhibitors, and environmental conditions.

Clinical forms of meningococcal arthritis: a study of five cases.

Five cases of meningococcal arthritis are described. Two clinical forms were observed: an early-onset acute polyarthritis (Type I) and a late-onset subacute monoarthritis (Type II). The 2 clinical subsets may represent sequential stages, an early bacteremic and a late stage of joint localization.

Leucapheresis in severe rheumatoid arthritis.

Two patients with severe seropositive rheumatoid arthritis previously unresponsive to conventional therapy have been treated with leucapheresis. This technique involves continuous cell separation daily to remove primarily lymphocytes. Clinical improvement was recorded with the use of standard rheumatological measures of inflammation.