Mycobacterium chelonae: a rare cause of subcutaneous nodules in a patient on long term corticosteroids
by Christopher Strickland and Ali S.M. Jawad
Subcutaneous nodules are a common clinical finding. Common causes include rheumatoid nodules, gouty tophi, neurofibromatosis type 1, Madelung’s disease (benign symmetric lipomatosis), Dercum’s disease (adiposis dolorosa) and tuberous xanthomas. Other causes include: hibernoma, lipoblastoma, angiolipoma, liposarcoma, glomus tumour, leiomyoma, eccrine spiradenoma, neuroma, granular cell tumour and cysts (epidermal, pilar, sebaceous, dermoid). We present a rare cause of subcutaneous nodules in a patient on long term corticosteroids. (Rheumatology: 29th January 2008) More...

Autoimmune neutropaenia complicating Sjögren’s Syndrome: haematological and clinical improvement with granulocyte colony stimulating factor
by M. D. Tarzi, S. Gupta, J Hanslip, H. J. Longhurst and A. S. M. Jawad
Connective tissue diseases are associated with granulocyte-specific autoantibodies and autoimmune neutropaenia. Reduced levels of circulating neutrophils may predispose to recurrent infections, particularly of the respiratory tract, although severe and opportunistic infections have also been reported. There is only one previous description of the use of granulocyte colony stimulating factor (GCSF) in Sjögren’s Syndrome complicated by autoimmune neutropaenia, reporting poor response and tolerability. We present here the successful use of GCSF in a 42-yearold woman with Sjögren’s Syndrome, autoimmune neutropaenia and chronic mastoiditis. (Rheumatology; 14th May 2007) More...

Subcutaneous oedema as a presenting feature of polymyositis/dermatomyositis: a poor prognostic indicator?
by Lisa Dunkley and Ali S. M. Jawad
Widespread subcutaneous oedema is a rare presenting feature of polymyositis (PM)/dermatomyositis (DM). It was reported in the initial description of the disease by Wagner in 1877 but only nine cases have since been reported in the literature and it is not listed in standard textbooks of rheumatology. We present a further case of subcutaneous oedema as a presenting feature of dermatomyositis, briefly review the existing literature and postulate that this presentation represents a subset of the disease with a poorer prognosis. (Rheumatology; 1st March 2007) More...

A case of rose thorn tenosynovitis
by Pamela Mangat and Ali S. M. Jawad
Penetrating injuries with retained foreign bodies are a frequent cause of synovitis affecting the extremities. The management of plant thorn synovitis raises a number of diagnostic and treatment challenges. (Rheumatology, Radiology; 20th February 2007) More...

A case of chronic non-erosive sero-negative polyarthritis associated with pyoderma gangrenosum
by Katherine Irving and Ali S. M. Jawad
We report a patient presenting with a seronegative polyarthritis who later developed pyoderma gangrenosum. The presumptive diagnosis was seronegative rheumatoid arthritis and associated pyoderma gangrenosum. However, the arthritis, although steroid responsive, did not respond to treatment with the usual DMARD therapies and appears to mirror the activity of the pyoderma gangrenosum. The normal X-rays, the negative rheumatoid factor and the normal colonoscopy are also consistent with a diagnosis of primary pyoderma gangrenosum with associated arthritis. (Rheumatology, Dermatology; May 1st 2006) More...

Paget's disease of bone in non-Caucasians in East London: a report of eight cases and a review of the literature
by Katherine Irving and Ali S. M. Jawad
Paget's disease of bone is more prevalent in populations of northern European origin and is thought to be rare in non-Caucasians. The population of the east end of London is multi-cultural with 45% from ethnic minorities. We report the case histories of eight non-Caucasian patients with Paget's disease of bone. (Rheumatology; April 2005) More...

Paget's disease by Ali S. M. Jawad and J. David Perry
Sir James Paget's seminal description of the clinical findings of the bone disease that now bears his name in 1877 holds true today, but his reference to the disease as osteitis deformans, implying an inflammation of the bone, is not accurate, and it is now called osteodystrophia deformans.. (Landmark Case Report; Rheumatology; November 2004) More...