Low dose prednisolone for treatment of RA.

We thank Dr Smith for alerting readers and us to the existence of his excellent paper that came out after our study was done and during the preparation of our manuscript. Our study described asymptomatic subjects, a somewhat different group from that in Dr Smith’s study—namely, patients with unexplained knee pain with clinically and arthroscopically normal knee joints. It is fascinating that in his study arthroscopy could not detect moderate inflammation seen in some biopsies. Thus, some synovitis can be present even when examinations and gross arthroscopy are normal. Future studies of patients like ours and those of Smith et al would benefit from longer follow up. What was the final cause of the knee pain that led to the need for arthroscopy? Will the cellular pattern be consistent, resolving, or progressive in some patients? Do the infiltrates seen in some ‘‘normal subjects’’ have any prognostic significance? It appears that our two studies 2 with many similar findings reinforce the point, also noted before by Lindblad and Hedfors, that there may be more variability in synovial histology and immunohistochemistry than many may have appreciated.