Multiple views detect more radiographic osteoarthritis than single views alone. When different combinations of views are used, the prevalence and compartmental distribution of osteoarthritis changes and this may alter the accepted relationship, or lack of it, between symptoms and radiographic change.

Mean range of internal rotation increased from 16 to 28 degrees at two weeks (p=0.03) and 23 degrees at 12 weeks (p=0.06). Functional ability did not change. Hips with an atrophic pattern of arthritis on plain radiography gained negligible pain relief at two weeks compared with hips with a hypertrophic or mixed bone response (p=0.04). The degree of pain relief was similar in patients with OA and RA, and was not influenced by radiographic severity or by the direction of migration of the femoral head. Conclusion-Pain and internal rotation improve for up to 12 weeks after CHI. CHI oVers a useful and safe therapeutic option for patients with hip arthritis, with the exception of those with a purely atrophic radiological pattern. (Ann Rheum Dis 1997;56:476-480) Arthritis of the hip is a significant cause of morbidity in the elderly population. Osteoarthritis (OA) is the commonest cause and aVects 4% of people over the age of 65 years.

It is important to continue FA supplementation over the long term in patients on methotrexate and FA in order to prevent them discontinuing treatment because of mouth ulcers or nausea and vomiting. Our data suggest that FA supplementation is also helpful in preventing neutropenia, with very little loss of efficacy of methotrexate.