A 6 year old child came with a h/o 1 year R knee monoarthritis. Had shown many Orthopedic surgeons & Paediatricians. Progressively developed R knee fixed flexion deformity and required to be carried upstairs to her classroom on the top floor everyday . She restricted fluids and diet to avoid needing to ambulate to the toilets and has early morning stiffness. Juvenile Idiopathic Arthritis can cause considerable deformity if not appropriately treated. After intra articular steroids one can see the improvement within 24 hours itself. DMARDs and physiotherapy are the next step
A 66-YEAR GENTLEMAN, WHO IS A KNOWN CASE OF DIABETES,HYPERTENSION AND COROANARY ARTERY DISEASE, DIAGNOSED TO HAVE RHEUMATOID ARTHRITIS 3 YEARS BACK,ON DMARD, NOW PRESENTED WITH FEVER, COUGH AND PROGRESSIVE BREATHLESSNESS.HE WAS TREATED CONVENTIONALLY.THE SYMPTOMS PROGRESSED.CHEST CT IMAGING SHOWED RIGHT SIDED PNEUMOTHORAX, PNEUMO MEDIASTINUM WITH EXTENSIVE SUBCUTANEOUS EMPHYSEMA IN THE RIGHT CHEST WALL. MULTIPLE NODULES IN THE LUNGS LIKELY REPRESENTING RHEUMATOID NODULES.HE WAS TREATED WITH ICD INSERTION,STEROIDS AND RITUXIMAB.NOW, PATIENT IS COMFORTABLE.