Electron microscopic study of depot corticosteroid crystals with clinical studies after intra-articular injection.
Depot corticosteroid crystals and their in vivo handling after intra-articular injection have not been studied by electron microscope (EM). We therefore injected 20 mg of either prednisolone tebuate or triamcinolone hexacetonide into knee joints of 7 patients with osteoarthritis and painful effusions. Six patients had a rise in the synovial fluid leukocyte counts, but only 1 patient had clinical evidence of a post-injection flare. Scanning and transmission EM revealed intra- and extracellular crystals 24 hours and 1 week after the initial injection. These combined EM studies provide an adjunct to compensated polarized microscopy in differentiation of depot steroid from other crystals.
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D001847:Bone Diseases / Q000188:drug therapy* / Q000473:pathology; D003460:Crystallization; D003692:Delayed-Action Preparations; D006801:Humans; D007270:Injections, Intra-Articular; D007592:Joint Diseases / Q000188:drug therapy* / Q000473:pathology; D007958:Leukocyte Count; D008854:Microscopy, Electron; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D013582:Synovial Fluid / Q000166:cytology*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects
D000305:Adrenal Cortex Hormones; D003692:Delayed-Action Preparations; D011239:Prednisolone; D014222:Triamcinolone Acetonide