Question 1

1. Is a local corticosteroid injection in the palm effective in the case of

Dupuytren's contracture?

2. Can Dupuytren's contracture occur in early or well-controlled

diabetes, or is it more likely to occur in uncontrolled diabetes?

Question 2

Besides cirrhosis of the liver and diabetes mellitus (DM), what other

causes of Dupuytren's contracture are there? What is the

pathophysiology behind it?

Question 3

According to one of my lecturers, who is a very well-qualified doctor

and orthopaedic specialist, there is an indirect connection between

osteoarthritis and subclinical local infections (such as periodontal

abscesses), changing the pH of bodily fluids. Can you explain this

mechanism?

Question 4

What do you mean by saying that in nodal osteoarthritis each joint is

affected one at a time? Is it that each proximal interphalangeal (PIP) or

distal interphalangeal (DIP) joint is affected alone, or that at any one time

PIP or DIP joints are affected together in one or both hands?

Question 5

What are the criteria for diagnosing osteoarthritis (OA) of the knee joint

radiologically? Are changes to be expected with advancing age? To what

extent would I consider it significant in those below 50 years of age?

Would you give me some X-ray examples if possible?

Question 6

1. In a young patient with osteoarthritis, does long-term treatment with

paracetamol (acetaminophen) 500 mg/day, rather than ibuprofen

600 mg/day, lower the incidence of renal toxicity?

2. How great is the risk of renal toxicity with both these treatments?

Question 7

In India, total knee replacements are being recommended for every case

of severe osteoarthritis, without considering factors such as age, weight

or medical condition. What are the correct indications for surgery?

Question 8

Methotrexate therapy is usually begun in rheumatoid arthritis that

doesn't respond to NSAIDs plus 40-120 mg methylprednisolone depot.

If a remission is then induced, how long should methotrexate therapy

be continued? Will the patient (now in remission) be given maintenance

therapy?

Question 9

What is the dose and regimen for folinic acid rescue after methotrexate in

rheumatoid arthritis?

Question 10

1. What are the indicators of remission in rheumatoid arthritis? Is it

normalization of erythrocyte sedimentation rate (ESR) or clinical

improvement?

2. Does the rheumatoid factor disappear during a remission of

rheumatoid arthritis?