Objective. To investigate the efficacy and tolerability of sulfasalazine (SSZ) in the treatment of early rheumatoid arthritis (RA). Methods. Eighty patients (symptomatic disease < 12 months) were randomly assigned to treatment with SSZ or placebo for 48 weeks. Clinical, laboratory, and scintigraphic data were used to determine the effects of treatment. Results. SSZ was superior to placebo in reducing the laboratory features of inflammation, the clinical parameters of disease activity, as well as the scintigraphic activity in the joints. Furthermore, fewer erosive changes developed in the joints of patients receiving active treatment, but the difference between treatment groups did not reach statistical significance. Conclusion. SSZ is effective in the treatment of RA, and its onset of action is rapid. The results support the view that SSZ retards the development of joint erosions. However, like other conventional disease‐modifying antirheumatic drugs, its remission‐inducing ability is insufficient.

Sixty patients with palindromic rheumatism (PR) with a total follow-up time of 598 years and 295 years prospectively are presented. The study shows that PR is not a rare condition, but the syndrome is often ignored or misdiagnosed by the physician. Most cases of PR appear to evolve into chronic arthritis. PR may precede other kinds of systemic diseases, such as SLE, Wegener's granulomatosis, and multiple myeloma. The presence of PR in patients with fibromyalgia is reported in this paper. Gold appears to be the best drug for the treatment of PR. Cases of fibromyalgia and PR are treated successfully with antimalarial drugs. Our proposed diagnostic criteria for PR are as follows: 1) recurrent attacks of sudden-onset mono or polyarthritis or of periarticular tissue inflammation, lasting from a few hours to one week; 2) verification of at least one attack by a physician; 3) subsequent attacks in at least three different joints; 4) exclusion of other forms of arthritides.

Sixteen cases of polymyositis (PM) were treated at the Central Hospital, Jyväskylä. Features of cardiac involvement were observed in 11 cases (69%). The heart diseases which developed or worsened after the onset of PM were grouped as follows: (1) Sole disturbance of conduction--one case, (2) congestive heart failure--four cases, (3) coronary heart disease with or without congestive heart failure--six cases. Three patients suffered an acute myocardial infarction. Electrocardiography revealed arrhythmias in eight cases and disturbances of conduction in three. In one patient complete atrioventricular block and congestive heart failure necesssitated installation of an intracardiac pacemaker. In four patients congestive heart failure progressed to death. In two autopsied cases changes suggestive of PM were found in the heart muscle. Involvement of the heart in PM was prognostically a bad sign.

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