This X-ray of the Pelvis belongs to a 33-year-old man. He was diagnosed to have Rheumatoid Arthritis 2 years ago but was not managed properly. He was only treated with steroids and pain killers by many doctors. He came to see me with pain over the left hip and inability to walk properly over the last few months. This X-ray shows a severe destruction of the left hip-joint with eroded acetabulum, making the hip-joint to protrude into the pelvis. We call this condition as Petrusio acetabulum.
I feel sad for this man as nothing much can be done for the damage that has already occurred. A difficult total hip replacement is possible but he is too young for this to be done unless the pain is unbearable.
- Petrusio Acetabulae in Rheumatoid Arthritis
Pagalavan's Avatar 
Dear Dr Pagavalan,
I would be grateful if you could tell which clinical practise guidelines for rheumatoid arthritis and SLE that are helpful for Malaysian physicians to follow.
There is no clinical practise guideline for these diseases as these diseases presents differently in each individual and the prognosis is also very much individualised. No 2 SLE patients are the same and thus it is very diffixult to come up with a guideline. We do have Gout management guideline.
Dear Doctor,
I stumbled on your blog while weighing the possibilities of pursuing studies in medicine. However, this article attracts me as my mother is diagnosed with rheumatoid arthritis around 15 years ago. Now she is 53 years old. At that time I was still young and do not know the severity of the sickness. I am now 31 years old and would like to know more on how I can help her. She is currently seeking treatment with Miri GH and I am not sure of the progress. What are my pointers? Is there a cure for her condition? What would be her worse case scenario? Hope to get a reply from you soon. TQ
Best regards,
Angie
There is NO cure for rheumatoid arthritis but it can be kept under control with medications. Worst case scenario: joint destructions
Is it a fairly common presentation, hip rheumatoid arthritis? As RA is typically a symmetrical small joint polyarthritis.