Spondyloepihyseal Dysplasia Congenita.

We describe a case of Spondyloepiphyseal Dysplasia Congenita (SEDc) who presented to our rheumatology clinic with complaints of painful swelling of bilateral elbow, knee, distal and proximal interphalangeal joints (DIP and PIP) of hands and small joints of foot. Patient also complained of restriction during extension of bilateral wrist joint and lateral rotation of neck on both sides. He was also unable to walk without support.

Management of Pregnancy in Lupus Patients.

Systemic lupus erythematosus (SLE) mostly affects young women of reproductive age group. SLE patients may conceive as any normal woman but complication may occur in these patients if the disease is active. Pregnancy in SLE may lead to 1. Aggravation of SLE (Lupus flare) 2. Pre-term delivery, intrauterine growth retardation and foetal loss (in presence of antiphospholipid antibodies) 3. Neonatal lupus especially in presence of Anti-Ro / La antibody. For a successful pregnancy, both from maternal and foetal aspects, disease should be quiescent for at least six months before the conception. Lupus patients with pregnancy require specific management to improve the maternal and fetal outcomes. Many safe drugs are available for the management of pregnancy in SLE.

Pachydermoperiostosis.

A case of Pachydermoperiostosis (PDP) presented to us in rheumatology clinic with complaints of enlargement and broadening of bilateral hands and feet, grade IV digital clubbing, coarsening of facial features, excessive sweating of the palms, soles during summers.

Alkaptonuric Ochronosis.

Alkaptonuria is an autosomal recessive metabolic disorder characterized by joints and spine involvement, ochronosis and presence of homogentisic acid in urine and its deposition in cartilage, intervertebral disc and other connective tissues, leading to disabling arthritis in elderly individual.