Ulnar drift: or what not to teach students

Article Abstract:

Diseases of the musculoskeletal system could more efficiently and profitably be taught to medical students if outdated, irrelevant, and useless information were eliminated. For example, most medical students are taught that ulnar drift is a diagnostic symptom of rheumatoid arthritis when in fact, it usually appears late in the course of the disease, does not relate to function, and has no diagnostic significance. Arguments that students should be taught to recognize patterns or that they need a routine and are incapable of critical thinking are specious and patronizing. Students should only be taught those elements of physical examination that will help them determine a possible diagnosis and decide what course of action to take next. This would make far more efficient use of their time. The course content of musculoskeletal diseases should be reviewed with this criterion in mind.

Medical students, Education, Study and teaching, Rheumatology

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Ulnar deviation is not always rheumatoid

Article Abstract:

Pigmented villonodular synovitis (PVNS) may be a rare but possible cause for some joint inflammation and deformities and can be detected by tissue sampling. A middle-aged female patient with no history of arthritis or other characteristic signs of frequently seen joint diseases developed an abnormal but painless deformity in both hands. Tissue and cellular evidence of PVNS were found during surgical reconstruction. No evidence of the deformity has been seen one year since the surgery. Studies have shown that the risk for repeat occurrences within 25 years after surgery is 65%.

Joints, Joints (Anatomy), Causes of, Complications and side effects, Inflammation, Synovitis

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Double blind glucocorticoid controlled trial of samarium-153 particulate hydroxyapatite radiation synovectomy from chronic knee synovitis

Article Abstract:

The authors wanted to determine if the use of Samarium-153, a radiation agent for chronic inflammation of the membranes inside joints, would improve the outcome of a synovectomy, or removal of that membrane. They found that after 12 months, it had no definite healing benefit compared to surgeries done without it.

Statistical Data Included, Surgery, Isotopes, Synovial membranes, Synovial membrane, Samarium

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