eLetters

410 e-Letters

  • Arterial stiffness is increased in rheumatoid arthritis
    Rainer Klocke

    Dear Editor,

    We thank Dr Chirinos for his interest in our article and appreciate his comments [1].

    We would disagree, however, with his suggestion that paired t-test is only appropriately used to analyze repeated measurements before and after an intervention in a single sample population. In our study the statistical analysis by a paired t-test was determined before data collection and based on the stu...

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  • Methylprednisolone confers no extra benefit in suprascapular nerve block
    Robert W Marshall

    Dear Editor,

    We read with interest the article by Shanahan et al [1] on suprascapular nerve blocks and the accompanying editorial by Hall and Buchbinder [2]. It is gratifying to know that in this context the indirect method of needle placement produces a similar outcome to the radiologically-guided method. However, we would like to point out an important methodological flaw in the study.

    The pat...

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  • Advantage of diascopy of the sacroiliac joints vs Barsony x-ray views
    Bozidar Curkovic

    Dear Editor,

    We read with interest the article by Rudwaleit et al [1]. "How to diagnose early spondyloarthropathy" and "Comment in leading" by Barkham et al [2]. We agree that MRI, particullary with the special techniques, could be very helpful in detecting signs of sacroiloiitis not yet visible on standard radiographs.

    MRI is most sensitive (95 %)and superior to Quantitative SI scintigraphy...

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  • Authors' reply
    CC Mok

    Dear Editor,

    We would like to thank Dr. Kumar for his interest in our report. He was very correct to point out the possibility of chronic subdural hematoma based on the CT appearance. In fact, chronic subdural effusion was the top differential diagnosis raised by our radiologist at that juncture.

    Simultaneous and subsequent follow-up MRI scans of the brain in our patient confirmed significant and diff...

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  • Interpretation of the WOSERACT data
    John R Kirwan

    Dear Editor,

    We read with interest the report of the WOSERACT trial [1] that compared the addition of 7 mg daily prednisolone or placebo to sulfasalazine in early rheumatoid arthritis (RA). There are a number of important aspects of the trial which have been dealt with well: the sample size is adequate; appropriate attention has been paid to confounders; two separate and independent readers scored the radiograph...

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  • Liver toxicity of infliximab in psoriatic arthritis
    Giuseppe Provenzano

    Dear Editor

    Feletar and colleagues have reported an interesting study concerning treatment with infliximab of refractory psoriatic arthritis.[1]

    They found a high incidence of liver toxicity, that occurred in 4/16 patients and led to discontinuation of infliximab in three patients. These data are rather surprising as to date hepatic toxicity has not been found to be a major concern with infliximab and ot...

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  • Chronic subdural haematoma should be considered with hypodense lesions on computerized tomography
    Sudhir Kumar

    Dear Editor

    It was interesting to read the recent report of systemic lupus erythematosus associated with atrophy of brain and spinal cord.[1] However, I would like to make certain observations.

    Computerised tomography (CT) of brain presented in the report showed bilateral hypodense lesions in the frontal and parietal regions. Though Mok et al attribute this CT appearance to diffuse cerebral atrophy; othe...

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  • Mischievous data mining of Registry Data
    Robert J Spiegel, M.D., FACP

    Dear Editor

    We read with interest the recent article of Jonsdottir and colleagues,[1] in which the authors describe an increase in the rate of ACLA in RA patients who received any anti-TNF therapy; a potentially very interesting finding. However, this article commits multiple errors in scientific methodology and we are concerned that the presumed apparent correlations of ACLA are actually the result of inherent b...

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  • Is arterial stiffness increased in rheumatoid arthritis?
    Julio A Chirinos

    Dear Editor

    I read the recent study by Klocke et al. with great interest.[1]

    The authors reported increased arterial stiffness as estimated by the analysis of arterial waveforms with aplanation tonometry in patients with rheumatoid arthritis (RA) when compared to healthy controls. Their findings can yield an important clue to understanding the increased cardiovascular mortality in RA. However, the...

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  • Continuous seeding of degraded products of normal micro-organisms as a causative factor in RA
    Adriaan C. Breebaart

    Dear Editor

    Toivanen [1] put forward the interesting hypothesis that, in contrast to reactive arthritis where temporary lodging of pathogenic micro- organisms is a causative factor, in RA a continuous seeding of degraded bacterial products from normal intestinal flora may induce synovitis. This hypothesis closely resembles the theory published by us one year earlier,[2] in which we also stressed a continuous seeding o...

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