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The study was performed in 55 RA patients and 47 controls. The ages of the RA patients were evenly distributed over the range 24-68 years. The average duration of the disease was less than 3 years. 100 mCi of 241Am was used as radiation source. Bone mineral density (BMD) was expressed as g/cm3. The measuring sites were the mid-point of the third metacarpal bone, the radius 1.5 cm distal to the head and the radius 10 cm from the head. The values for each measuring site were calculated by dividing the bone index (g/cm) by the cross-sectional area of the bone. At the mid-radius and the distal radius the BMD was significantly lower in the RA patients than in the controls. The differences were 8% and 10% respectively. At the third metacarpal the difference (5%) was not significant. The osteoporotic effect of RA seemed to intensify with age. The duration of the disease was not correlated with BMD. Serial BMD measurements in RA cases of recent onset revealed no clear decrease in BMD. A significant correlation was found between BMD and the following factors: Systemic and local technetium index of joints, X-ray grade, ESR. Sex, functional capacity, grip strength, Waaler-Rose titre and serum alkaline phosphatase were not related to BMD. It is concluded that general osteoporosis in RA is usually slight and closely related to the inflammatory process.

The effect of conducted training begun at an early age on the femoral head tilt was studied in male adolescent competitive sportsmen and physical education students. The control group consisted of army recruits. The femoral head tilt proved to be smaller in both sportsmen and physical education students when compared with the control subjects. The results suggest that sports activities started at an early age would not contribute to epiphysiolysis and through that to later development of osteoarthritis in the hip joint.

43 rheumatoid knees with persistent effusion were treated by intra-articular injections of triamcinolone hexacetonide (40 mg) or combined triamcinolone-osmic acid. Both treatments produced long-lasting improvements in the treated knees. Osmic acid seemed to potentiate the effect of the steroid. This was demonstrated by measurement of joint circumference and local 99mTc uptake. In the general clinical evaluation the difference between the treatments was not noticeable. The percentage of 'excellent' and 'good' improvements was 36 at 12 months in the steroid-group and 44 in the steroid-osmic acid group.

The distribution of 90Y resin colloid in the synovial fluid is a simple dispersion between two colloidal systems. 90Y particles are rapidly phagocytized by synovial fluid cells, as shown by radioautography. In synovial biopsies taken for electron microscopic study 3 or 6 days after therapeutic isotope injection, the 90Y particles were abundant in vacuolar cavities among the intercellular ground substance. This is considered to be the route by which 90Y leaks into the lymph stream. The acute effect of the isotope was due to damage of the synovial cells and superficial synovium.

The accumulation of Tc-99m in knee and finger joints was studied in 41 rheumatic patients and 25 controls. The accumulation of the radioisotope was correlated with the intensity of active inflammation. Rheumatoid joints showed a stronger Tc-99m uptake than joints with osteoarthritis. There was some overlap, however, which limits the value of the method. The effect of local and systemic anti-rheumatic treatments could be followed with joint scanning.Radioactivity was also measured in the synovial fluid but this fraction of the Tc-99m was not large. The synovial fluid radioactivity tended to increase as the Tc-99m accumulation in the knee area decreased. Accumulation of Tc-99m in joints is regarded as principally due to the enhanced circulation in inflamed joint tissues.