The authors discuss the use of pulsed methylprednisolone therapy in severe ankylosing spondylitis. They conducted a double-blind, crossover study involving 10 patients, divided into two groups: Group A received three 1 g pulses of methylprednisolone on alternate days, while Group B received placebo infusions. The study found that pulsed methylprednisolone was well tolerated, with only minor adverse effects. However, it did not significantly improve morning stiffness or pain scores compared to placebo infusions plus physiotherapy. The authors conclude that pulsed methylprednisolone may be effective for severe ankylosing spondylitis of recent onset but is inappropriate for other categories of patients. They suggest that a combination of non-steroidal anti-inflammatory drugs and physiotherapy is more suitable for most patients. The authors share the surprise that Brown's syndrome, an ocular complication of rheumatoid arthritis, is not more frequently encountered. They report a similar case where bilateral superior oblique tendon sheath problems resolved with local corticosteroid injections. The authors note that they have seen four well-recorded cases since their original report and are curious about why "trigger eye" is less common than "trigger finger" in rheumatoid arthritis. They speculate that external trauma might be a contributing factor. The author points out labeling errors in Figure 1 of an article on magnetic resonance imaging (MRI) of the shoulder. They also emphasize that MRI is still too expensive for common use and that its sensitivity is often not surpassed by other modalities like plain X-rays or arthrography.The authors discuss the use of pulsed methylprednisolone therapy in severe ankylosing spondylitis. They conducted a double-blind, crossover study involving 10 patients, divided into two groups: Group A received three 1 g pulses of methylprednisolone on alternate days, while Group B received placebo infusions. The study found that pulsed methylprednisolone was well tolerated, with only minor adverse effects. However, it did not significantly improve morning stiffness or pain scores compared to placebo infusions plus physiotherapy. The authors conclude that pulsed methylprednisolone may be effective for severe ankylosing spondylitis of recent onset but is inappropriate for other categories of patients. They suggest that a combination of non-steroidal anti-inflammatory drugs and physiotherapy is more suitable for most patients. The authors share the surprise that Brown's syndrome, an ocular complication of rheumatoid arthritis, is not more frequently encountered. They report a similar case where bilateral superior oblique tendon sheath problems resolved with local corticosteroid injections. The authors note that they have seen four well-recorded cases since their original report and are curious about why "trigger eye" is less common than "trigger finger" in rheumatoid arthritis. They speculate that external trauma might be a contributing factor. The author points out labeling errors in Figure 1 of an article on magnetic resonance imaging (MRI) of the shoulder. They also emphasize that MRI is still too expensive for common use and that its sensitivity is often not surpassed by other modalities like plain X-rays or arthrography.