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We present 22 cases with inter-sterno-costoclavicular ossification. Clinical and pathological findings show that abnormal ossification observed in this situation is due to non-suppurative chronic inflammation of the soft tissues around the sterno-costo-clavicular region such as the costo-clavicular ligament. We have classified X-ray findings into three stages according to the extent of the ossification; localized, generalized, and hyperostotic, and show that the disease progressed in this sequence. A considerable number of the patients showed abnormal X-ray findings in the spine or the sacro-iliac joint. Frequent association of pustulosis palmaris et plantaris was noted in this disease. Most of the cases were treated effectively with anti-inflammatory drugs, but a few cases required surgical resection of the ossified mass with the clavicle or the first rib in order to relieve the severe pain.

With good perioperative medical management of RA, surgical repositioning of the metatarsophalangeal joints by proximal metatarsal shortening and consequent relaxing of the surrounding soft tissue shows successful long-term results.

SUMMARY Eighty-eight Japanese patients with rheumatoid arthritis and 104 normal Japanese persons were typed for HLA A, B, C, and DR antigens. The frequency of HLA DR4 was 70 * 5 % in patients compared with 461 % in normal controls (P<0 00 1). However, a sex difference in the frequency of HLA DR4 in patients was noted. HLA DR4 was found in 80 6% of male patients, which was highly significant compared with controls (P<0 '0005), while only a borderline increase to 60 5% was found in female patients (P<0 05). In addition, the frequency of HLA DR2 was remarkably low in male patients. These suggest the possible heterogeneity of rheumatoid arthritis in Japanese. In the study reported here Japanese patients with rheumatoid arthritis were typed for HLA DR antigens to see whether the same association was present as was the case in the Caucasian patients. Materials and methodsEighty-eight patients who were diagnosed as classical or definite rheumatoid arthritis according to the

We here report different protein profiles of BMACs between RA and OA for the first time. BMACs possessing differently expressed proteins may be involved in the pathophysiology of the two diseases.

MRI is gaining attention as a tool for examining the severity of osteoarthritis (OA) over X-ray findings. However, there are few reports on the relationship between MRI and X-ray findings in ankle joints. We assessed the combination of ankle joint alignment and MRI to find the factor to predict MRI findings from X-ray findings in OA. Methods: Of the 341 patients who had a diagnosis of ankle OA in our hospital from May 2009 to August 2015, we assessed 46 feet of 45 patients who underwent MRI. We determined ankle joint alignment by measuring tibial anterior surface (TAS) angle, and tibial lateral surface (TLS) angle on X-ray, and determined the areas of Bone Marrow Edema (BME) appearing on STIR, by partitioning 22 areas for talocrural, tarocalcaneal, Chopart joint. In the statistics analysis, we divided into two groups with and without BME, and we compared TAS angle and TLS angle. Moreover, for predicting the occurrence of BME, we divided the disease group into 2 groups, training set and validation set. We then verified the validity of the results by measuring cutoff value of TAS angle and TLS angle from ROC curve, an area which had statistically significant difference. Results: TAS angles or TLS angles were significantly lower in the group which showed BME at the anterior medial part of the tibia canopy and medial malleolus joint surface. From the ROC curve of the training set, the cutoff value (TAS angle of 82 degrees or less and TLS angle of 76 degrees or less) was obtained. Applying the obtained cutoff value to the validation set, it was possible to predict the occurrence of BME on the medial malleolus joint surface (sensitivity 71%, specificity 67%). Conclusion: Association with BME and clinical symptoms as well as disease prognosis has been reported in the OA area, so predicting the appearance of BME can be a useful index for prescribing a treatment plan. It was suggested that the appearance of BME could be predicted from X-ray findings because it was related to ankle alignment and MRI. It is possible that these findings could be used as a new diagnostic tool to estimate disease severity in the future.

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