Objective To analyze abnormal gait patterns in patients with rheumatoid arthritis involving the knee joint. Methods In 2 patient groups with rheumatoid arthritis, changes in relevant angular parameters in the sagittal plane were analyzed by an electromagnetic tracking instrument. One group consisted of patients with knee joint involvement and severe inflammation without progressive destruction; the other group had knee joint involvement with progressive destruction and low disease activity. Knee angle was measured as the projected angle in the sagittal plane formed by 3 sensors (hip–knee–ankle); the changing mean angle, angular velocity, and angular acceleration were displayed. Furthermore, the angle formed by the vector element's endpoints for each sensor's displacement (designated α angle) was measured continuously. Results Compared with age‐matched controls, patients with severe inflammatory knee joint involvement showed limitation of α angle change in the stance phase, and patients with knee joint destruction had shortened swing phase duration and decreased α angle change in the swing phase. A sharpened α angular velocity change curve was observed in the latter. Characteristic differences between groups with inflammation and destruction were more clearly evident from the α angle than from the knee angle itself. Conclusion We observed gait differences between rheumatoid arthritis patients with active inflammatory arthritic knee joint involvement without progressive destruction and those with joint destruction and minimal inflammation. Features of gait disturbance in rheumatoid arthritis were not simple, even with a single major site. Therefore, techniques such as biokinetic gait analysis can provide practical information about functional joint integrity in this patient population that could aid in therapeutic decision making. Arthritis Care Res 45:35–41, 2001. © 2001 by the American College of Rheumatology.

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[Summary]A case of systemic lupus erythematosus (SLE) with interstitial pneumonitis developing concurrently with antibiotics administration is reported.A 50-year-old woman was administered amoxicillin by a practitioner because of fever and arthralgia, but she remained febrile. On admission to our hospital, initial studies revealed leukopenia, positive LE cells, positive antinuclear antibody, high titer of anti-DNA antibodies, and hypocomplementemia. Chest X-ray films showed minimal interstitial changes. The diagnosis of SLE was made and prednisolone, 60 mg daily, was started. Her symptoms and laboratory findings, including chest X-ray abnormalities improved, and the dose of prednisolone was tapered. When prednisolone was tapered to 35 mg daily, she was given cephalexin for sinusitis. A few days following the antibiotics therapy, fever, cough and dyspnea gradually appeared, and diffuse interstitial changes developed on chest X-ray films. Prednisolone was tapered to 30 mg, cephalexin was discontinued, and ampicillin, followed by cefinenoxime were administered. However, her clinical symptoms became progressively worse associated with densely infiltrative interstitial changes in both lungs. Combination therapy with INH and trimethoprim-sulfamethoxazole was added. About one week after the beginning of cefmenoxime, eosinophilia and high level of serum LDH appeared. Drug-induced pneumonitis was suspected and cefmenoxime was discontinued. Consequently, clinical symptoms , laboratory data, and interstitial pneumonitis on chest films improved promptly. Histopathologic examinations of a transbronchial biopsy specimen discolsed alveolar septal thickening with fibrosis, and perivascular lymphocytic infiltration, compatible with the diagnosis of interstitial

The purpose of the present study was to determine (1) whether the pattern of gait with a short leg brace definitely deviated from that of normal gait, and (2) whether a hybrid mass-spring pendulum model proposed in a systems approach was applicable to walking with a short leg brace. Thirty healthy young adults participated in this study. Step rate and Physiological Cost Index during walking on a treadmill were measured while the participants were wearing (a) short leg brace(s) on one leg or on both legs. Walking velocities were 33.3-100.0 m/min for males and 16.7-83.3 m/min for females. The optimal energy-saving gait when using a short leg brace exhibited deviation from the normal gait pattern, because step length was smaller and the step rate was higher. When the velocity exceeded 90 m/min, however, step length was longer and step rate was lower in short leg brace gait than in normal gait. We thought some modifications to the hybrid model were necessary to explain our results.