Spinal and hip osteopenia and vertebral fractures are a feature of mild AS. However, there was no correlation between BMD and vertebral fractures in these patients. AS patients with mild disease had a higher risk of fractures compared with the normal population and this increased with the duration of disease.

The clinical and histological features of 'mechanic's hands' are described in a patient with polymyositis characterized serologically by antibodies to histidyl tRNA synthetase (Jo-1). Although described in the past in association with polymyositis, these distinctive cutaneous lesions have only recently been associated with the 'anti-synthetase syndrome'. It is becoming apparent that recognition of subsets within the spectrum of polymyositis/dermatomyositis characterized by certain clinical and serological features not only have prognostic significance, but also may provide insights into mechanisms of disease.

Objective. To investigate leukocyte lipocortin-1 production in rheumatoid arthritis (RA).Methods. Eight control and 8 RA subjects received 100 mg hydrocortisone intravenously. Leukocyte lipocortin-1 was measured by enzyme-linked immunosorbent assay.Results. Hydrocortisone induced significant increases in lipocortin-1 production by control mononuclear cells (MNC) (P = 0.006 versus baseline) but not by RA MNC (P = 0.44 versus baseline). Peak lipocortin-1 levels in control MNC were significantly higher than those in RA MNC (P = 0.014). Conchsion. These results indicate that glucocorticoid-induced MNC lipocortin-1 production is impaired in RA.Glucocorticoid hormones are used widely in the therapy of inflammatory diseases including rheumatoid arthritis (RA). The use of glucocorticoids is associated with not inconsiderable morbidity, but it has continued because of the broad spectrum of antiinflammatory effects these drugs possess. Endogenous