A letter to the editor discusses the use of pulsed methylprednisolone therapy in rheumatoid arthritis and ankylosing spondylitis. The authors agree with previous studies that pulsed methylprednisolone is a useful adjunct in rheumatoid arthritis. They also tested this therapy in severe ankylosing spondylitis, finding it well tolerated with only minor side effects. However, the results were disappointing compared to rheumatoid arthritis, with only minor improvements in symptoms. The study showed that pulsed methylprednisolone was effective in severe, longstanding ankylosing spondylitis, suggesting that inflammatory processes may not be the main cause of pain and stiffness in these patients. The authors suggest that pulsed methylprednisolone may be considered for severe ankylosing spondylitis of recent onset where inflammation may play a major role, but not for other categories of patients. They also note that non-steroidal anti-inflammatory drugs and physiotherapy are sufficient for most patients. Another letter discusses Brown's syndrome, an unusual ocular complication of rheumatoid arthritis. The authors share the authors' surprise that this syndrome is not more frequently encountered, but point out that they reported a similar case in 1980. They note that their patient had similar features to the case reported by Cooper et al, including systemic features of rheumatoid disease and 'early morning stiffness of the eyes'. The authors are curious as to why 'trigger eye' is not as common as 'trigger finger' in rheumatoid disease, as the pathology is identical. A third letter comments on an article about magnetic resonance imaging. The author points out that items 7 and 8 in fig 1 are incorrectly labeled. They also note that magnetic resonance imaging is still too expensive for common use in studying pathological processes, and that reproducible sensitive results depend on the radiologist.A letter to the editor discusses the use of pulsed methylprednisolone therapy in rheumatoid arthritis and ankylosing spondylitis. The authors agree with previous studies that pulsed methylprednisolone is a useful adjunct in rheumatoid arthritis. They also tested this therapy in severe ankylosing spondylitis, finding it well tolerated with only minor side effects. However, the results were disappointing compared to rheumatoid arthritis, with only minor improvements in symptoms. The study showed that pulsed methylprednisolone was effective in severe, longstanding ankylosing spondylitis, suggesting that inflammatory processes may not be the main cause of pain and stiffness in these patients. The authors suggest that pulsed methylprednisolone may be considered for severe ankylosing spondylitis of recent onset where inflammation may play a major role, but not for other categories of patients. They also note that non-steroidal anti-inflammatory drugs and physiotherapy are sufficient for most patients. Another letter discusses Brown's syndrome, an unusual ocular complication of rheumatoid arthritis. The authors share the authors' surprise that this syndrome is not more frequently encountered, but point out that they reported a similar case in 1980. They note that their patient had similar features to the case reported by Cooper et al, including systemic features of rheumatoid disease and 'early morning stiffness of the eyes'. The authors are curious as to why 'trigger eye' is not as common as 'trigger finger' in rheumatoid disease, as the pathology is identical. A third letter comments on an article about magnetic resonance imaging. The author points out that items 7 and 8 in fig 1 are incorrectly labeled. They also note that magnetic resonance imaging is still too expensive for common use in studying pathological processes, and that reproducible sensitive results depend on the radiologist.