Rheumatoid arthritis (RA) is a lifelong, systemic autoimmune disease that affects women three times more frequently than men, often in their most productive and childbearing years. This chronic inflammatory disease occurs mainly due to immunological dysfunction and infiltration of T cells secreting cytokines causing inflammation and arthritis due to cartilage destruction and systemic symptoms. The primary feature being inflammatory synovitis which usually involves the peripheral joints. The mainstay of management of rheumatoid arthritis includes Disease Modifying Antirheumatic Drugs (DMARDs), most of which are contraindicated in pregnancy, thus causing a significant complexity in management during pregnancy. In our case, A 28 year old female, Primigravida with 26 weeks of gestation came to the OPD of department of Obstetrics and Gynaecology, MGM hospital with complaints of pain in the left knee joint for the past one year, aggravated two weeks back and diffuse swelling over the joint since 1 month. A diagnosis of monoarticular Rheumatoid arthritis was formed after ruling out other pathologies like reactive arthritis, tuberculosis of knee joint, referred pain due to pathologies in the neighbouring joints. Since the patient was pregnant, a decision based on level five evidence, was taken to avoid the DMARDs due to their potential teratogenicity and she was managed with an intra-articular injection of corticosteroid which showed no improvement in the patient's symptoms. Hence it was followed by an intra-articular injection of 8ml of Platelet rich plasma (PRP) which resulted in an improvement in VAS scores from 8 to 2, 4weeks after injection along with a clinical reduction in joint swelling and pain even at extremes of movements. The clinical benefits of PRP in RA can possibly be explained by its antiinflammatory effects.

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Introduction: Osteochondroma is a type of cartilaginous tumor. It is the most common benign tumor of axial skeleton usually arising around the knee, proximal humerus, and pelvis. Solitary osteochondroma of the scapula is relatively rare and usually incidental finding accompanied by pain and dysfunction. These lesions can easily be followed radiographically with plain radiograph. Computed tomography (CT) is used to determine the precise location and its relationship with the surrounding soft tissues and enable accurate surgical removal. Case Report: In this report, we present a rare case of a symptomatic scapular osteochondroma in a 18-year-old male who presented with the complaints of swelling over the left scapula. X-ray showed a bony outgrowth along the posteromedial border of the left scapula. CT scan was done to know extent of the growth. MRI was performed to rule out soft-tissue involvement. Despite the young age of the patient, surgical excision was performed. The outcome was good, the patient noticed disappearance of swelling and a normal profile of the scapula was gained. Conclusion: We have described a rare case of scapular osteochondroma associated with different signs, symptoms, and positive radiological findings. This lesion was removed surgically, and a follow-up indicated complete symptom relief with no history of recurrence. By reporting this case, we aim to increase the awareness of unusual manifestations of osteochondroma, particularly in terms of site, age of onset, and atypical presenting signs and symptoms.

Introduction: The present case report describes an acute reconstruction of extensor hallucis longus (EHL) tendon with defect treated using looped extensor hallucis brevis (EHB) tendon graft. Case Report: A 40 year male manual labor had an acute traumatic EHL tear which was repaired at a primary health care center. After 2 days, the patient felt a sudden click and a re-tear at zone IV of EHL. Since there was a defect of 3.5 cm which was not amenable for primary repair, EHB graft was used for the reconstruction in a loop fashion. The foot and ankle disability index score was 95.2 at 2 years follow-up with grade 4 + power. Conclusion: EHB graft is a good alternative to other autografts for extensor hallucis longus reconstructions with good clinical and functional outcomes.

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