Importance of synovial fluid aspiration when injecting intra-articular corticosteroids

Ann Rheum Dis. 2000 Mar;59(3):233-5. doi: 10.1136/ard.59.3.233.

Abstract

Objective: The aim of this prospective study was to find if a complete synovial fluid aspiration before injecting intra-articular corticosteroids influences the treatment result.

Methods: The study was performed in 147 patients with rheumatoid arthritis (RA). One hundred and ninety one knees with synovitis were randomised to arthrocentesis (n=95) or no arthrocentesis (n = 96) before 20 mg triamcinolone hexacetonide was injected. The duration of effect was followed up for a period of six months. All patients were instructed to contact the rheumatology department if signs and symptoms from the treated knee recurred. If arthritis could be confirmed by a clinical examination a relapse was noted.

Results: There was a significant reduction of relapse in the arthrocentesis group (p = 0.001).

Conclusion: The study shows that aspiration of synovial fluid can reduce the risk for arthritis relapse when treating RA patients with intra-articular corticosteroids. It is concluded that arthrocentesis shall be included in the intra-articular corticosteroid injection procedure.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular
  • Knee Joint*
  • Male
  • Middle Aged
  • Prospective Studies
  • Suction
  • Synovial Fluid*
  • Synovitis / drug therapy
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / analogs & derivatives*
  • Triamcinolone Acetonide / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Triamcinolone Acetonide
  • triamcinolone hexacetonide