Idiopathic EN is common. A basic procedure including careful medical history-taking, a physical examination for peripheral synovitis, 2 consecutive ASO determinations, a tuberculin skin test, and chest radiography may be sufficient to diagnose EN.

RVD or PHT are a frequent finding at diagnosis in patients with hemodynamically stable pulmonary embolism and they persist at 6 months in a significant proportion of cases. We have observed a relationship between the persistence of residual vascular obstruction in CTPA and RVD or PHT 6 months after PE.

Persistent pulmonary vascular obstruction on 6-month CTPA did not predict long-term adverse outcome events.

The patient, a 76-year-old woman, presented to the hospital because of pain and swelling in the first metatarsophalangeal (MTP) joint. She reported having progressive pain and swelling in the right great toe, which had begun 6 months earlier. At that time she was diagnosed as having gout and was treated with nonsteroidal antiinflammatory drugs (NSAIDs), colchicine, and allopurinol, without improvement. At the present visit, no abnormalities were observed on physical examination, apart from arthritis involving the right first MTP joint. Laboratory studies revealed elevations in the erythrocyte sedimentation rate (53 mm/hour) and C-reactive protein level (1.0 mg/dl); no abnormalities in other laboratory parameters, including serum uric acid and creatinine levels, were found. Chest radiography results were normal. A positive reaction (26 mm) was demonstrated on intracutaneous tuberculin skin testing (purified protein derivative). Open synovial biopsy disclosed caseating granulomata, and culture of the synovium was positive for Mycobactenurn tuberculosis.

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