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Although arthroscopic removal is the usual treatment for intra-articular tophi, surgery is not always an option. This Case Study demonstrates that continuous urate-lowering therapy is a suitable alternative: in a 67-year-old man, painful locking of the knee secondary to intra-articular tophi was alleviated following continuous allopurinol therapy. Resolution of the tophi was demonstrated by CT.
Scleroderma-like disorders, which often have marked clinical overlap with scleroderma, can present a diagnostic challenge. In this Viewpoint, the author describes key clinical and laboratory features that can aid early diagnosis and prompt appropriate management.
Bone mineral density testing is used to diagnose osteoporosis, assess the associated fracture risk and monitor changes over time. In this Review, the authors describe the common technical and interpretation errors that are encountered in the clinical use of bone densitometry, with a primary focus on DXA.