Treatment of bilateral superior oblique tendon sheath syndrome complicating rheumatoid arthritis.

A 63-year-old retired mining engineer with rheumatoid arthtitis presented in November 1976 with intermittent diplopia on upward gaze. His diplopia became increasingly troublesome, particularly on waking, and he was admitted under the care of the rheumatologists for investigation in February 1977. He had a 6-year history of seropositive erosive rheumatoid arthritis with numerous extra-articular features, including weight loss, subcutaneous nodules, Raynaud's phenomenon, mild bilateral carpal tunnel syndrome, nail fold vasculitis, hepatosplenomegaly and pericarditis.