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Rheumatology (Oxford). 2012 Jul;51(7):1299-303. doi: 10.1093/rheumatology/kes027. Epub 2012 Mar 5.

CS injection of tenosynovitis in patients with chronic inflammatory arthritis: the role of US.

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1
Clinica Reumatologica, Università Politecnica delle Marche, Ospedale 'C. Urbani', 52, Via dei Colli, 60035 - Jesi, Ancona, Italy. lucadigeso@libero.it

Abstract

OBJECTIVE:

The main aim of this study was to investigate the short-term efficacy of CS loco-regional treatment performed under US guidance in tenosynovitis of patients with chronic inflammatory arthritis.

METHODS:

Thirty consecutive patients affected by chronic arthritis and with clinical suspicion of tenosynovitis were recruited to undergo US assessment. In the sonographically proven cases, US-guided CS injection was performed. A visual analogue scale for pain (ranging from 0 to 10) and a tenderness score (ranging from 0 to 3) were used for the clinical evaluation. Sonographic pathological findings indicative of tenosynovitis were scored using a semi-quantitative 4-grade scoring system, for both grey-scale and power Doppler US, at baseline and during a follow-up visit at 2 weeks after the CS injection.

RESULTS:

In 21 (70%) of 30 patients, the clinical suspicion of tenosynovitis was confirmed (9 with RA, 11 with PsA and 1 with ReA). In the other nine patients, US revealed synovitis of the adjacent joints, bursitis, oedema of the s.c. tissue or a partial tear. In all cases the appropriate needle placement and subsequent CS injection into the tendon sheath were obtained with US confirmation. A significant reduction in all clinical and sonographic scorings was found during the follow-up visit.

CONCLUSIONS:

The present study shows the efficacy of US-guided peritendinous CS injections in the management of patients with chronic inflammatory arthritis presenting as US-proven tenosynovitis.

PMID:
22393028
DOI:
10.1093/rheumatology/kes027
[Indexed for MEDLINE]
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