Kodama S, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-223387 Description A 48-year-old Japanese woman with non-small cell lung adenocarcinoma (cT3N2M1b) received nivolumab (an immune checkpoint inhibitor) at a dosage of 3 mg/kg every 2 weeks. Treatment with nivolumab was effective. The primary tumour as well as metastases to the lymph nodes and spine almost completely disappeared, as shown o...

Forty-two shoulders in 37 patients with polyarthritis were treated with Neer total shoulder replacements and reviewed 12 to 66 months afterwards. There was good pain relief and improvement in function, but the range of movement was less than that seen after replacements for osteoarthritis; this may have been related to the fact that 34 shoulders had abnormal rotator cuff tendons. Although there...

Sir, Rheumatoid nodules have been reported to occur in about 20% of patients with chronic rheumatoid polyarthritis (1, 2). In the recent literature, a correlation between treatment of rheumatoid arthritis with methotrexate and the development or worsening of rheumatoid nodules has been suggested (2 ± 4). We describe here the explosive deterioration of rheumatoid nodules during the course of met...

Eight of 11 patients who satisfy Smythe's criteria for the 'fibrositis' syndrome have subsequently developed carpal tunnel syndrome. Six of the 8 patients have gone on to develop an inflammatory polyarthritis, 3 of whom are seropositive and satisfy the criteria for classical rheumatoid arthritis. The relationship between the 'fibrositis' syndrome and rheumatoid arthritis is not clear, but the a...

A 68-year-old man presented with polyarthritis, proximal muscle weakness, and erythema of the face, arms, neck, and anterior chest that resembled the V-neck sign. Initially, dermatomyositis (DM) was considered because of the erythema, polyarthritis, and muscle weakness. He also had mediastinal and hilar lymphadenopathy on contrast-enhanced computed tomography. Unexpectedly, a biopsy of the fore...