Symptomatic tendon subluxation after surgical release for deQuervain's disease treated by Brachioradialis tendon flap

Symptomatic palmar subluxation of the abductor pollicis longus and the extensor pollicis brevis tendons developed in a 23 years old man after surgical release for deQuervain's disease. The sub- luxation occurred with the wrist in flexion and the thumb in pal- mar abduction. Nonoperative treatment was ineffective. Surgery was performed to reconstruct a new tendon restraint using a distally based flap from the brachioradialis tendon. Twenty months postoperatively the patient was free of tendon subluxation or pain and had full motion and power of his wrist

Diastolic function abnormalities in rheumatoid arthritis; an echocardiographic study

The aim of this study was to evaluate left ventricular-filling in patients with rheumatoid arthritis [RA], analyzing transmitral flow and pulmonary venous flow, with special regard to disease duration. Forty-five patients affected by RA according to ARA criteria were selected, without evidence of cardiac disease, and compared with matched control subjects. All patients and control group were submitted to M-mode, two- dimensional Doppler and color Doppler [continuous and pulsed wave] echocardiography. Transmitral flow [E/A ratio], pulmonary venous flow [S/D ratio], IVRT and DT. In RA patients, left ventricular filling abnormalities were found to be characterized by a reduced E/A ratio. It was concluded that RA patients, in the absence of clinical evidence of heart disease, show LV diastolic dysfunction characterized by impaired E/A and S/D ratio. The relation with the disease duration suggests a sub-clinical myocardial involvement

Rheumatic disorders in virus-C hepatitis patients

To study the incidence of rheumatologic disorders in chronic hepatitis C infection. Fifty patients suffering from chronic hepatitis C [Positive HCV antibody and PCR] of more than six months duration were included in the study. Another group of twenty-five patients with rheumatic manifestations free of HCV served as a control group. They were identical in gender and age. Among the HCV patients group cryoglobulinaemia was detected in 29 cases [58%], antinuclear antibodies in 1 0 cases [20%] rheumatoid factor in 19 cases [38%], hypocomplementaemia in 20 cases [40%], myalgia in 24 cases [48%], arthralgia in 26 cases [52%] arthritis in 18 cases [36%] enthesitis in 39 cases [78%], fatigability in 46 cases [92%], Raynaud's Phenomenon in 14 cases [28%], xerophthaimia in 1 0 cases [20%], rash in 29 cases [58%], carpal tunnel syndrome in 6 cases [1 2%] and R A in 6 cases [1 2%]. HCV may play a role in the pathogenosis of these auto immune phenomena. This hypothesis is mainly based on the lymphotropism of HCV that can be responsible for a chronic activation of both T and B lymphocytes, leading to complex immune system disorders. But more studies are required to define the extent of this role

Bone degradation in RA patients receiving glucocorticoids

This study was conducted on 120 patients suffering from RA classified into four groups in addition to 20 normal control. Regarding base line level of deoxypyridinoline [DPD], there was no significant difference between all groups and controls. Bone resorption increased for RA without glucocorticoids [GCs] and those receiving 5 mg/d of prednisolone but not significantly elevated than controls. For RA patients who received 10 mg/d of prednisolone, there was a significant increase in bone resorption. For RA patients who received 15 mg/d of prednisolone, there was much increase in bone resorption. After six months, doses of GCs for 10 mg and 15 mg were tapered with an apparent decrease in bone resorption