Naproxen sodium and piroxicam in acute musculo-skeletal disorders

Of one hundred patients originally entered for this trial eighty-three with acute musculo-skeletal disorders were treated with either naproxen sodium (SYNFLEX, Syntex), 550 mg initially followed by 275 mg four times daily, or piroxicam (FELDENE, Pfizer), 20 mg twice daily for two days then 20 mg once daily. Patients were assessed at admission, on day 4 and on day 8. Pain on passive movement, tenderness, swelling and limitation of function were evaluated and patients also completed a daily self-assessment form. Pain relief was recorded by the patient for 4 hours following the first dose. No statistically significant differences were detected between the treatment groups for any of the efficacy measurements. Of the eighty-three patients analysed, twenty-four patients withdrew from treatment twenty of whom did not need further analgesia (13 in the naproxen sodium group and 7 in the piroxicam group). Three patients experienced side-effects; all were in the piroxicam group, and one patient withdrew from the study because of epigastric pain. Both naproxen sodium and piroxicam proved effective in the treatment of musculo-skeletal disorders. Naproxen sodium did not give rise to any side-effects.     

Influence of HLA-A2 on the effectiveness of platelet transfusions in alloimmunized thrombocytopenic patients

Platelet transfusions from donors selectively mismatched for cross- reactive and certain non-cross-reactive HLA antigens were found to be more effective in HLA-A2 negative than in HLA-A2 positive, alloimmunized thrombocytopenic patients. The two groups of patients responded equally well to platelets matched for antigens of the HLA-A and B loci. Certain alloimmunized patients negative for HLA-A2 continued to respond satisfactorily to platelets selectively mismatched for non-cross-reactive HLA antigens as long as platelets containing HLA- A2 were avoided. The data indicate that platelet transfusion support can be provided within a broader range of donor-recipient HLA antigenic disparity to HLA-A2 negative alloimmunized patients than to those who are positive for this antigen.     

MR imaging of the normal shoulder

Magnetic resonance (MR) images of the shoulders of a healthy volunteer were obtained in axial, sagittal, and coronal orientations using a 0.5-T imaging system. Multiple high-resolution spin-echo images were generated using an off-center zoom technique and a specially designed surface coil. Several anatomic structures, including the rotator cuff, long biceps tendon, articular capsule, muscles, and bones, were visualized. The coronal and sagittal views were the most useful for demonstrating the rotator cuff. MR imaging has potential as a new non-invasive tool for the evaluation of the shoulder region.     

Detection of intra-articular osteochondral bodies in the knee using computed arthrotomography

A new technique using air arthrography followed by computed tomography enables identification of free osteocartilaginous fragments in the knee joint. Clinical examples with useful diagnostic information are presented, and potential pitfalls in the interpretation of this information are discussed.