In rheumatoid arthritis (RA) such early radiographic changes as soft tissue swelling and osteoporosis may well be reversible. Narrowing of the joint space and bone erosion are late changes generally considered to be non-reversible. Our observation suggest, however, that healing of bone erosions, especially in joints in which inflammation had disappeared, is more common than is generally believed. We describe three patients with classical RA in whom serial radiographs showed that the bone erosion in one or more of the joints of their hands or feet had healed.

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Twenty-eight patients with rheumatoid pleural effusion were investigated to examine the frequency of HLA antigens as compared with 56 rheumatoid arthritis (RA) patients without this intrathoracic manifestation of RA and with 283 healthy controls. HLA-B8 was strongly associated with the presence of pleural effusion (PE) in RA patients. A high prevalence (71%) of B8/Dw3 was found among male RA patients of the PE group in whom the joint disease had begun at an age over 50 years and who also had besides pleuritis other intrathoracic manifestations of RA associated with high rheumatoid factor titres and low complement (C4) levels in sera. Actually, the HLA-B8 association was not seen in the rest of the PE group. The finding may be related to the heterogeneity of RA, a male subgroup of the disease being characterized by multiple intrathoracic manifestations and genetically associated with the large group of autoimmune disorders, such as SLE, characterized by high prevalences of HLA-B8 and D(R)3.

In 66 patients with rheumatoid knee joint synovitis and hydrops and with only slight radiological destruction, local treatment of the knee was randomly performed either with osmic acid, radioactive yttrium or surgical synovectomy. After a one-year follow-up the clinical and radiological results were slightly better in patients who underwent surgical synovectomy than in other treatment groups. However, radiological osteoarthrosis had progressed more in synovectomized patients than in others. In 2 patients with radioactive yttrium a relapse requiring surgical synovectomy was seen. Because osmic acid is almost as effective as surgical synovectomy, is very cheap and easy to perform, it can be recommended as the first choice for local therapy in patients with corticosteroid-restant knee joint synovitis, in the early stage of the disease.

Naproxen levels in serum, synovial fluid and synovium of eighteen patients with "classical" or "definite" rheumatoid arthritis and chronic knee effusion were studied. After oral administration of 250 mg naproxen twice daily, naproxen levels in synovial fluid were found to be more than half as high as in serum. Even in synovium itself naproxen levels were appreciable.