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© 1993 British Society for Rheumatology

case-report

MECHANISM OF JOINT SPARING IN A PATIENT WITH UNILATERAL PSORIATIC ARTHRITIS AND A LONGSTANDING HEMIPLEGIA

D. VEALE, M. FARRELL* and O. FITZGERALD

St Vincent's Dublin, Eire
*Beaumont Hospitals Dublin, Eire

Correspondence to: Correspondence to: Oliver FitzGerald, Department of Rheumatology, St Vincent's Hospital, Elm Park, Dublin 4, Eire

The case of a 59-year-old female with a longstanding hemiplegia who developed unilateral psoriatic arthritis and unilateral psoriasis on the non-hemiplegic side only is reported. Investigations showed an erythrocyte sedimentation rate of 58 mm/h, with all classes of rheumatoid factor negative in serum and synovial fluid (SF). An inflammatory infiltrate was demonstrated in both knee joints despite the absence of clinical involvement on the hemiplegic side. In addition, while neurofilament and substance P (SP) immunoreactivity was demonstrated in both synovial specimens, conspicuously less SP was present in the clinically involved synovial membrane. Finally, SF levels of SP and IL1ß were raised in the clinically involved knee only.

KEY WORDS: Synovial membrane, Substance P, Interleukin 1ß


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