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At the end of a double blind clinical test carried out in 35 patients with classical rheumatoid arthritis, or progressive and with certain diagnosis, it does not appear that zinc sulphate given by mouth at dose of 600 mg/24 hours (divided up into 3 doses) may be a valid basic treatment. In fact, none of the classical clinical criteria (Richtie index, Lee index, etc.) nor laboratory criteria (E.S.R.) show any statistically significant change after 4 and 8 months. The discrepancy between these results and those previously published in discussed.

Erosions of vertebral bodies and intervertebral discs are usually considered as late manifestations of ankylosing spondylitis. Yet they may occur early and indeed constitute the first sign of the disease. This is illustrated by the case reported here, where a 19-year-old woman with an 18-months diagnosis of ankylosing spondylitis was found to have severe destructive lesions of the 6th cervical vertebra without discal lesion nor cervical ankylosis. Surgical biopsy excluded a tumoral or infectious process. Spinal fusion (C4-C7) was performed, and cervical pain was completely relieved with non-steroidal anti-inflammatory drugs.

During a retrospective study of the records of 9 patients with dermatomyositis, pulmonary lesions were noted in 4 cases. Dermatomyositis had been diagnosed on clinical, biochemical, electrical and histopathological criteria. Patients with other connective tissue disease associated with dermatomyositis were excluded. In one case the pulmonary lesions preceded the clinical symptoms of dermatomyositis. Two patients had interstitial pneumonia and 2 presented with reticulonodular images suggestive of diffuse interstitial fibrosis. The outcome after corticosteroid and/or immunosuppressive therapy was favourable in 3 cases. It would appear from this study that clinical and radiological signs of pulmonary lesions and respiratory insufficiency are abnormally frequent in dermatomyositis and that the prognosis in such cases is perhaps brighter than is usually believed.

The inferior oblique isolated damage in the systemic lupus erythematosus is being described. The ocular palsies are few and exceptionally isolated. Few studies have been published on the damage topography which can relate to micro-infarcts, or focal vasculitis. The involvement is either central or peripheral. The diagnosis by NMR is more reliable than by TDM.

We have evaluated the therapeutic effect of the calcium-channel blocking agent nifedipine in Raynaud's phenomenon associated with connective tissue diseases and in idiopathic digital vasospasm. Thirty patients were included in this study: Raynaud's phenomenon was associated with progressive systemic sclerosis (PSS) in ten patients, systemic lupus erythematosus (SLE) in five and rheumatoid arthritis (RA) in three; it was idiopathic (I) in twelve patients. Each patient received, in a double-blind manner and random order, on two consecutive weeks, nifedipine (20 mg three times daily) and placebo. Nifedipine proved to be effective: the mean number of digital vasospastic attacks per week decreased from 20.30 to 5.83 (p less than 0.01). The results in the SLE and RA groups were similar and were pooled. The improvement (in percent decrease) was better in the idiopathic group (90.95) than in the SLE and RA group (78.63, p less than 0.02) and the PSS group (64.02, p less than 0.01).

32 cases of hemarthrosis observed in 26 patients suffering from articular chondrocalcinosis are used as a basis for a review of the principal clinical anc paraclinical findings. Special mention is made of the fact that hemarthrosis occurs in the shoulder much less rarely than has been classically reported. The diagnostic value of finding microcristals of calcium pyrophosphate in hemorrhagic fluid is also emphasized. In addition to standard treatment, isotopic synoviortheses is shown to be effective for treatment of recurrent hemarthrosis. After an average of 3.3 years of follow-up, this treatment, although lacking certain analgesic effect, frequently leads to lasting cessation of the hemarthrosis, more often it seems, in the shoulder than in the knee.